PHILLIP D MODERSOHN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049047078

License Status

NOT RENEWED

Business

First Name

PHILLIP D

Last Name

MODERSOHN

Business Name

PHILLIP D MODERSOHN

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

SANDWICH

State

Zip

60548

County

DEKALB

Ever Disciplined

LastModifiedDate

10/17/2005