NANCY SIVERTSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049063206

License Status

NOT RENEWED

Business

First Name

NANCY

Last Name

SIVERTSEN

Business Name

NANCY SIVERTSEN

Original Issue Date

03/28/1975

Effective Date

03/28/1975

Expiration Date

01/01/1997

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005