CARLY MICHELLE BURCHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049237931

License Status

NOT RENEWED

Business

First Name

CARLY

Middle

MICHELLE

Last Name

BURCHAM

Business Name

CARLY MICHELLE BURCHAM

Original Issue Date

11/24/2015

Effective Date

11/24/2015

Expiration Date

03/31/2016

City

STAUNTON

State

Zip

62088

County

MACOUPIN

Ever Disciplined

LastModifiedDate

05/20/2016