STACEY SIMON LEVEQUE Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051033949

License Status

INACTIVE

Business

First Name

STACEY

Middle

SIMON

Last Name

LEVEQUE

Business Name

STACEY SIMON LEVEQUE

Original Issue Date

07/30/1981

Effective Date

09/02/2009

Expiration Date

03/31/2010

City

GALENA

State

Zip

61036

County

JO DAVIESS

Ever Disciplined

LastModifiedDate

01/05/2010