GAVIN ROBERT LONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049249505

License Status

NOT RENEWED

Business

First Name

GAVIN

Middle

ROBERT

Last Name

LONG

Business Name

GAVIN ROBERT LONG

Original Issue Date

03/30/2017

Effective Date

03/26/2018

Expiration Date

03/31/2019

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Ever Disciplined

LastModifiedDate

07/15/2019