MARY KATHRYN NISSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049048410

License Status

NOT RENEWED

Business

First Name

MARY KATHRYN

Last Name

NISSEN

Business Name

MARY KATHRYN NISSEN

Original Issue Date

10/25/1960

Effective Date

10/25/1960

Expiration Date

03/31/2003

City

GREENVIEW

State

Zip

62642

County

MENARD

Ever Disciplined

LastModifiedDate

10/20/2005