SHANE A DEMOSS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049141357

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

DEMOSS

Business Name

SHANE A DEMOSS

Original Issue Date

03/12/2002

Effective Date

03/12/2002

Expiration Date

03/31/2003

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/20/2005