DAVID A NISSEN - Pharmacist License in Missouri | # 051286411

DAVID A NISSEN

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051286411

License Status

INACTIVE

Business

N

First Name

DAVID

Middle

A

Last Name

NISSEN

Business Name

DAVID A NISSEN

Original Issue Date

12/11/1997

Effective Date

03/31/2004

Expiration Date

03/31/2006

State

MO

Ever Disciplined

N

LastModifiedDate

01/18/2006