DIANA R BURGESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049216060

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

Last Name

BURGESS

Prefix

Business Name

DIANA R BURGESS

Original Issue Date

02/15/2013

Effective Date

02/15/2013

Expiration Date

03/31/2014

City

VALIER

State

Zip

62891

County

FRANKLIN

Ever Disciplined

LastModifiedDate

05/06/2014