DIANNE M CHAMPLIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049077339

License Status

NOT RENEWED

Business

First Name

DIANNE M

Last Name

CHAMPLIN

Business Name

DIANNE M CHAMPLIN

Original Issue Date

11/08/1982

Effective Date

11/08/1982

Expiration Date

03/31/1997

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005