PAULENE R PETRUTIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049235722

License Status

NOT RENEWED

Business

First Name

PAULENE

Middle

Last Name

PETRUTIS

Prefix

Business Name

PAULENE R PETRUTIS

Original Issue Date

08/22/2015

Effective Date

03/14/2016

Expiration Date

03/31/2017

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/10/2017