MATTHEW R DIERKS - Pharmacist License in Indiana | # 049168567

MATTHEW R DIERKS

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049168567

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

R

Last Name

DIERKS

Business Name

MATTHEW R DIERKS

Original Issue Date

05/10/2006

Effective Date

05/10/2006

Expiration Date

03/31/2007

State

IN

Ever Disciplined

N

LastModifiedDate

05/14/2007