DIANA M SAMUELSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049235492

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

Last Name

SAMUELSON

Prefix

Business Name

DIANA M SAMUELSON

Original Issue Date

08/13/2015

Effective Date

02/08/2016

Expiration Date

03/31/2017

City

POPLAR GROVE

State

Zip

61065

County

BOONE

Ever Disciplined

LastModifiedDate

05/10/2017