SAMANTHA L STALEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143180

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

STALEY

Business Name

SAMANTHA L STALEY

Original Issue Date

06/13/2002

Effective Date

06/13/2002

Expiration Date

03/31/2006

City

HIGHLAND

State

Zip

46332

Ever Disciplined

LastModifiedDate

05/11/2006