DAVID LEE GORTAT Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029998

License Status

INACTIVE

Business

First Name

DAVID LEE

Last Name

GORTAT

Business Name

DAVID LEE GORTAT

Original Issue Date

08/02/1974

Effective Date

03/31/2004

Expiration Date

03/31/2006

City

HIGHLAND

State

Zip

46322

County

INDIANA

Ever Disciplined

LastModifiedDate

01/18/2006