BRADLEY J BASTIAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049085780

License Status

NOT RENEWED

Business

First Name

BRADLEY J

Last Name

BASTIAN

Business Name

BRADLEY J BASTIAN

Original Issue Date

12/22/1987

Effective Date

12/22/1987

Expiration Date

03/31/1989

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005