BAILEE OLIVIA VANANTWERP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049220173

License Status

NOT RENEWED

Business

First Name

BAILEE

Middle

OLIVIA

Last Name

VANANTWERP

Business Name

BAILEE OLIVIA VANANTWERP

Original Issue Date

08/21/2013

Effective Date

02/23/2015

Expiration Date

03/31/2016

City

ALBUQUERQUE

State

Zip

87102

Ever Disciplined

LastModifiedDate

05/20/2016