SHANE MICHAEL JAMES DEWITT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049230832

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

MICHAEL JAMES

Last Name

DEWITT

Business Name

SHANE MICHAEL JAMES DEWITT

Original Issue Date

01/28/2015

Effective Date

01/28/2015

Expiration Date

03/31/2016

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/20/2016