MALLORY K LARSSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049171635

License Status

NOT RENEWED

Business

First Name

MALLORY

Middle

Last Name

LARSSON

Business Name

MALLORY K LARSSON

Original Issue Date

09/26/2006

Effective Date

04/19/2011

Expiration Date

03/31/2012

City

MOAB

State

Zip

84532

Ever Disciplined

LastModifiedDate

05/07/2012