SUSANNAH K KOCH MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049220678

License Status

NOT RENEWED

Business

Title

First Name

SUSANNAH

Middle

Last Name

KOCH

Prefix

Business Name

SUSANNAH K KOCH MD

Original Issue Date

09/09/2013

Effective Date

02/14/2014

Expiration Date

03/31/2015

City

SAVOY

State

Zip

61874

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/11/2015