TIAIRRA LATICE PAGE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049281634

License Status

NOT RENEWED

Business

First Name

TIAIRRA

Middle

LATICE

Last Name

PAGE

Business Name

TIAIRRA LATICE PAGE

Original Issue Date

04/16/2021

Effective Date

05/17/2022

Expiration Date

03/31/2023

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/07/2023