MARK WAYNE JOHNSEN - Pharmacist License in Illinois | # 049062705

MARK WAYNE JOHNSEN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062705

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005