DEA SULLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049274753

License Status

NOT RENEWED

Business

First Name

DEA

Last Name

SULLIVAN

Business Name

DEA SULLIVAN

Original Issue Date

08/03/2020

Effective Date

01/10/2021

Expiration Date

05/31/2022

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/27/2022