PHYLLIS A LANE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049109828

License Status

NOT RENEWED

Business

First Name

PHYLLIS A

Last Name

LANE

Business Name

PHYLLIS A LANE

Original Issue Date

03/17/1995

Effective Date

03/17/1995

Expiration Date

03/31/1999

City

PRAORIE DU CHIEN

State

Zip

53821

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005