KELLY A WIESE - Pharmacist License in Wisconsin | # 049122572

KELLY A WIESE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122572

License Status

NOT RENEWED

Business

N

First Name

KELLY

Middle

A

Last Name

WIESE

Business Name

KELLY A WIESE

Original Issue Date

08/25/1998

Effective Date

08/25/1998

Expiration Date

03/31/2002

State

WI

Ever Disciplined

N

LastModifiedDate

12/06/2005