WAYNE E LARSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057834

License Status

NOT RENEWED

Business

First Name

WAYNE E

Last Name

LARSON

Business Name

WAYNE E LARSON

Original Issue Date

06/07/1972

Effective Date

06/07/1972

Expiration Date

01/01/1997

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005