AMANDA RAE BIVENS - Pharmacist License in Illinois | # 049264814

AMANDA RAE BIVENS

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049264814

License Status

NOT RENEWED

Business

N

First Name

AMANDA

Middle

RAE

Last Name

BIVENS

Business Name

AMANDA RAE BIVENS

Original Issue Date

04/22/2019

Effective Date

10/29/2021

Expiration Date

05/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022