GARY LEE NISSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049059954

License Status

NOT RENEWED

Business

First Name

GARY LEE

Last Name

NISSEN

Business Name

GARY LEE NISSEN

Original Issue Date

07/20/1973

Effective Date

07/20/1973

Expiration Date

01/01/1997

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005