DEBRA M MIKOLASZ KLOCKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049064977

License Status

NOT RENEWED

Business

First Name

DEBRA M MIKOLASZ

Last Name

KLOCKE

Business Name

DEBRA M MIKOLASZ KLOCKE

Original Issue Date

03/05/1976

Effective Date

03/05/1976

Expiration Date

01/01/1997

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/17/2005