SHANE WILSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049255083

License Status

NOT RENEWED

Business

First Name

SHANE

Last Name

WILSON

Business Name

SHANE WILSON

Original Issue Date

12/19/2017

Effective Date

02/22/2018

Expiration Date

03/31/2019

City

SPRINGFIELD

State

Zip

19064

Ever Disciplined

LastModifiedDate

07/15/2019