MICHAEL THOMAS WIESBROOK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061593

License Status

NOT RENEWED

Business

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

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Ever Disciplined

LastModifiedDate

10/17/2005