HEATHER LYNN BASHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156797

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

LYNN

Last Name

BASHAM

Business Name

HEATHER LYNN BASHAM

Original Issue Date

08/19/2004

Effective Date

08/19/2004

Expiration Date

03/31/2005

City

INDIANAPOLIS

State

Zip

46235

County

INDIANA

Ever Disciplined

LastModifiedDate

10/20/2005