PENNY MARLENE DAUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049066021

License Status

NOT RENEWED

Business

First Name

PENNY MARLENE

Last Name

DAUM

Business Name

PENNY MARLENE DAUM

Original Issue Date

09/03/1976

Effective Date

09/03/1976

Expiration Date

01/01/1997

City

HIGHLAND

State

Zip

62249

County

MADISON

Ever Disciplined

LastModifiedDate

10/17/2005