THOMAS P WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057622

License Status

NOT RENEWED

Business

First Name

THOMAS P

Last Name

WAGNER

Business Name

THOMAS P WAGNER

Original Issue Date

04/18/1972

Effective Date

04/18/1972

Expiration Date

01/01/1997

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Ever Disciplined

LastModifiedDate

10/17/2005