KEITH N MIERZWA Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049066852

License Status

CANCELLED

Business

First Name

KEITH N

Last Name

MIERZWA

Business Name

KEITH N MIERZWA

Original Issue Date

02/25/1977

Effective Date

02/25/1977

Expiration Date

01/01/1997

City

MCHENRY

State

Zip

60050

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/17/2005