GARY L NISSEN Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057024

License Status

CANCELLED

Business

First Name

GARY L

Last Name

NISSEN

Business Name

GARY L NISSEN

Original Issue Date

10/29/1971

Effective Date

10/29/1971

Expiration Date

01/01/1997

City

MISSOURI VALLEY

State

Zip

51555

County

IOWA

Ever Disciplined

LastModifiedDate

10/17/2005