THOMAS M MAMBOURG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049093101

License Status

NOT RENEWED

Business

First Name

THOMAS M

Last Name

MAMBOURG

Business Name

THOMAS M MAMBOURG

Original Issue Date

05/12/1990

Effective Date

05/12/1990

Expiration Date

03/31/1998

City

MUNSTER

State

Zip

46321

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005