SHANE D MADSEN - Pharmacist License in Wisconsin | # 049177394

SHANE D MADSEN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049177394

License Status

NOT RENEWED

Business

N

First Name

SHANE

Middle

D

Last Name

MADSEN

Business Name

SHANE D MADSEN

Original Issue Date

06/28/2007

Effective Date

03/29/2012

Expiration Date

03/31/2013

State

WI

Ever Disciplined

N

LastModifiedDate

05/06/2013