Evansco, Micki M - (Pharmacist)
New Athens, MO 62264
License# : 2014037979 - Issued on : 10/24/2014
Doing Business As :
| Licensee Name: | Evansco, Micki M |
| Profession Name: | Pharmacist |
| Licensee Number: | 2014037979 |
| Expiration Date: | 10/31/2016 |
| Original Issue Date: | 10/24/2014 |
| Address: | |
| Address Con't: | |
| City, State Zip: | New Athens, IL 62264 |
| County: | Unknown/Out of State |
| Practitioner DBA Name: | |
| Classification: |
| Current Discipline Status: | None |
Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists
