CONNIE DIANA LONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049056564

License Status

NOT RENEWED

Business

First Name

CONNIE DIANA

Last Name

LONG

Business Name

CONNIE DIANA LONG

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

ST LOUIS

State

Zip

63116

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/17/2005