MACKENZIE JEAN TATICEK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049273294

License Status

NOT RENEWED

Business

First Name

MACKENZIE

Middle

JEAN

Last Name

TATICEK

Business Name

MACKENZIE JEAN TATICEK

Original Issue Date

05/15/2020

Effective Date

05/15/2020

Expiration Date

03/31/2021

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/20/2021