RANDY OCTAVIAN WEST Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133604

License Status

NOT RENEWED

Business

First Name

RANDY

Middle

OCTAVIAN

Last Name

WEST

Business Name

RANDY OCTAVIAN WEST

Original Issue Date

11/13/2000

Effective Date

11/13/2000

Expiration Date

03/31/2002

City

RACINE

State

Zip

53403

County

WISCONSIN

Ever Disciplined

LastModifiedDate

12/06/2005