STEVEN LYLE WAGNER Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057990

License Status

CANCELLED

Business

First Name

STEVEN LYLE

Last Name

WAGNER

Business Name

STEVEN LYLE WAGNER

Original Issue Date

06/24/1972

Effective Date

06/24/1972

Expiration Date

01/01/1997

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/17/2005