PHILLIP J WIESE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131215

License Status

NOT RENEWED

Business

First Name

PHILLIP

Middle

Last Name

WIESE

Business Name

PHILLIP J WIESE

Original Issue Date

06/15/2000

Effective Date

02/15/2011

Expiration Date

03/31/2012

City

DAVENPORT

State

Zip

52807

County

IOWA

Ever Disciplined

LastModifiedDate

05/07/2012