RANDOLPH MICHAEL INGRAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049271276

License Status

NOT RENEWED

Business

First Name

RANDOLPH

Middle

MICHAEL

Last Name

INGRAM

Business Name

RANDOLPH MICHAEL INGRAM

Original Issue Date

02/26/2020

Effective Date

03/10/2021

Expiration Date

05/31/2022

City

WOODLAWN

State

Zip

62898

County

JEFFERSON

Ever Disciplined

LastModifiedDate

07/27/2022