LYDIA LYNNE DEROUSSE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049265672

License Status

NOT RENEWED

Business

First Name

LYDIA

Middle

LYNNE

Last Name

DEROUSSE

Business Name

LYDIA LYNNE DEROUSSE

Original Issue Date

05/30/2019

Effective Date

05/30/2019

Expiration Date

09/30/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

01/08/2021