DANE R LEIST - Pharmacist License in Wisconsin | # 049176399

DANE R LEIST

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049176399

License Status

NOT RENEWED

Business

N

First Name

DANE

Middle

R

Last Name

LEIST

Business Name

DANE R LEIST

Original Issue Date

05/17/2007

Effective Date

01/25/2010

Expiration Date

03/31/2011

State

WI

Ever Disciplined

N

LastModifiedDate

05/12/2011