ELLIS O DIAZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210016

License Status

NOT RENEWED

Business

First Name

ELLIS O

Last Name

DIAZ

Business Name

ELLIS O DIAZ

Original Issue Date

03/30/2012

Effective Date

02/05/2013

Expiration Date

03/31/2014

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

05/06/2014