DANA MICHELLE SMALL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049258956

License Status

NOT RENEWED

Business

First Name

DANA

Middle

MICHELLE

Last Name

SMALL

Business Name

DANA MICHELLE SMALL

Original Issue Date

08/02/2018

Effective Date

08/02/2018

Expiration Date

03/31/2019

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/15/2019