NICOLE DANETTE STALLWORTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049123062

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

DANETTE

Last Name

STALLWORTH

Business Name

NICOLE DANETTE STALLWORTH

Original Issue Date

10/05/1998

Effective Date

01/27/2014

Expiration Date

03/31/2015

City

SCHERERVILLE

State

Zip

46375

County

INDIANA

Ever Disciplined

LastModifiedDate

05/11/2015