BRENT MOALLANKAMP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049278606

License Status

NOT RENEWED

Business

First Name

BRENT

Last Name

MOALLANKAMP

Business Name

BRENT MOALLANKAMP

Original Issue Date

01/11/2021

Effective Date

01/11/2021

Expiration Date

05/31/2022

City

ULLIN

State

Zip

62992

County

PULASKI

Ever Disciplined

LastModifiedDate

07/27/2022