DAYLEN FORTSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049288995

License Status

NOT RENEWED

Business

First Name

DAYLEN

Last Name

FORTSON

Business Name

DAYLEN FORTSON

Original Issue Date

12/20/2021

Effective Date

12/20/2021

Expiration Date

05/31/2022

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/27/2022