ANDREA J WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049102325

License Status

NOT RENEWED

Business

First Name

ANDREA J

Last Name

WAGNER

Business Name

ANDREA J WAGNER

Original Issue Date

02/03/1993

Effective Date

02/03/1993

Expiration Date

03/31/1997

City

NAPLES

State

Zip

34104

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/17/2005

Case Number

1996008968

Action

Suspension

Discipline Start Date

06/20/1997

Discipline Reason

Outstanding tax liability owed the Illinois Department of Revenue.