JEFFREY R O'BANNER MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131794

License Status

NOT RENEWED

Business

Title

First Name

JEFFREY

Middle

Last Name

O'BANNER

Business Name

JEFFREY R O'BANNER MD

Original Issue Date

07/25/2000

Effective Date

07/25/2000

Expiration Date

03/31/2003

City

SOUTHAVEN

State

Zip

38671

Ever Disciplined

LastModifiedDate

10/20/2005