KELLIE N BERGSTROM - Pharmacist License in Wisconsin | # 049128202

KELLIE N BERGSTROM

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049128202

License Status

NOT RENEWED

Business

N

First Name

KELLIE

Middle

N

Last Name

BERGSTROM

Business Name

KELLIE N BERGSTROM

Original Issue Date

11/15/1999

Effective Date

01/19/2006

Expiration Date

03/31/2007

State

WI

Ever Disciplined

N

LastModifiedDate

05/14/2007