MARK WAYNE JOHNSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062705

License Status

NOT RENEWED

Business

First Name

MARK WAYNE

Last Name

JOHNSEN

Business Name

MARK WAYNE JOHNSEN

Original Issue Date

12/20/1974

Effective Date

12/20/1974

Expiration Date

03/31/1984

City

CHICAGO

State

Zip

60641

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005