STANLEY PETERSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061256

License Status

NOT RENEWED

Business

First Name

STANLEY

Last Name

PETERSEN

Business Name

STANLEY PETERSEN

Original Issue Date

04/08/1974

Effective Date

04/08/1974

Expiration Date

01/01/1997

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005