MICHAEL WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049059569

License Status

NOT RENEWED

Business

First Name

MICHAEL

Last Name

WAGNER

Business Name

MICHAEL WAGNER

Original Issue Date

05/24/1973

Effective Date

05/24/1973

Expiration Date

01/01/1997

City

OTTAWA

State

Zip

61350

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/17/2005