ANTAWN A SOUFFRANT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049235433

License Status

NOT RENEWED

Business

First Name

ANTAWN

Middle

Last Name

SOUFFRANT

Prefix

Business Name

ANTAWN A SOUFFRANT

Original Issue Date

08/12/2015

Effective Date

08/12/2015

Expiration Date

03/31/2016

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

05/20/2016