DIANNA M MALCOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049229090

License Status

NOT RENEWED

Business

First Name

DIANNA

Middle

Last Name

MALCOM

Prefix

Business Name

DIANNA M MALCOM

Original Issue Date

11/07/2014

Effective Date

11/07/2014

Expiration Date

03/31/2015

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2015