LESLIE R PETERSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049072289

License Status

NOT RENEWED

Business

First Name

LESLIE R

Last Name

PETERSEN

Business Name

LESLIE R PETERSEN

Original Issue Date

12/26/1979

Effective Date

12/26/1979

Expiration Date

03/31/1991

City

ELGIN

State

Zip

60120

County

KANE

Ever Disciplined

LastModifiedDate

10/17/2005