SAMUEL CURTIS BAISLEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049259723

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

CURTIS

Last Name

BAISLEY

Business Name

SAMUEL CURTIS BAISLEY

Original Issue Date

09/19/2018

Effective Date

02/06/2019

Expiration Date

09/30/2020

City

KENOSHA

State

Zip

53143

Ever Disciplined

LastModifiedDate

01/08/2021