SHANE A GOGANTHOMAS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049238748

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

GOGANTHOMAS

Prefix

Business Name

SHANE A GOGANTHOMAS

Original Issue Date

01/07/2016

Effective Date

03/31/2017

Expiration Date

03/31/2018

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

06/19/2018