SUSAN LYNN DETTM FAHLER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057943

License Status

NOT RENEWED

Business

First Name

SUSAN LYNN DETTM

Last Name

FAHLER

Business Name

SUSAN LYNN DETTM FAHLER

Original Issue Date

06/24/1972

Effective Date

06/24/1972

Expiration Date

01/01/1997

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

10/17/2005