ELLEN MATHENIA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049269901

License Status

NOT RENEWED

Business

First Name

ELLEN

Last Name

MATHENIA

Business Name

ELLEN MATHENIA

Original Issue Date

12/18/2019

Effective Date

12/18/2019

Expiration Date

09/30/2020

City

STAUNTON

State

Zip

62088

County

MACOUPIN

Ever Disciplined

LastModifiedDate

01/08/2021