DEREK COBURN SCOTT CAZARES TAPIA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049312755

License Status

NOT RENEWED

Business

First Name

DEREK

Middle

COBURN SCOTT

Last Name

CAZARES TAPIA

Business Name

DEREK COBURN SCOTT CAZARES TAPIA

Original Issue Date

06/05/2024

Effective Date

06/05/2024

Expiration Date

03/31/2025

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

08/08/2025