TIFFANY BROOKE FOWLER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049215107

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

BROOKE

Last Name

FOWLER

Business Name

TIFFANY BROOKE FOWLER

Original Issue Date

12/20/2012

Effective Date

12/20/2012

Expiration Date

03/31/2013

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

05/06/2013