DIANE LYNN MARTIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051030341

License Status

NOT RENEWED

Business

First Name

DIANE LYNN

Last Name

MARTIN

Business Name

DIANE LYNN MARTIN

Original Issue Date

03/07/1975

Effective Date

02/14/2018

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021