MICHAEL THOMAS WIESBROOK - Pharmacist License in Illinois | # 049061593

MICHAEL THOMAS WIESBROOK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061593

License Status

NOT RENEWED

Business

N

First Name

MICHAEL THOMAS

Last Name

WIESBROOK

Business Name

MICHAEL THOMAS WIESBROOK

Original Issue Date

05/29/1974

Effective Date

05/29/1974

Expiration Date

01/01/1997

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005