NATHAN EDWARD PAYNE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049267976

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

EDWARD

Last Name

PAYNE

Business Name

NATHAN EDWARD PAYNE

Original Issue Date

09/23/2019

Effective Date

09/23/2019

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

01/08/2021