LESLIE WAYNE RUSSELL Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051030580

License Status

INACTIVE

Business

First Name

LESLIE WAYNE

Last Name

RUSSELL

Business Name

LESLIE WAYNE RUSSELL

Original Issue Date

07/25/1975

Effective Date

01/21/2014

Expiration Date

03/31/2016

City

RICHVIEW

State

Zip

62877

County

WASHINGTON

Ever Disciplined

LastModifiedDate

01/28/2016