DARRYL D IVANSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051290856

License Status

NOT RENEWED

Business

First Name

DARRYL

Middle

Last Name

IVANSON

Business Name

DARRYL D IVANSON

Original Issue Date

02/18/2005

Effective Date

01/16/2018

Expiration Date

09/30/2020

City

SPRINGVILLE

State

Zip

47462

County

INDIANA

Ever Disciplined

LastModifiedDate

01/14/2021