NATHAN K WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049089549

License Status

NOT RENEWED

Business

First Name

NATHAN K

Last Name

WAGNER

Business Name

NATHAN K WAGNER

Original Issue Date

04/11/1989

Effective Date

04/11/1989

Expiration Date

03/31/1990

City

PEORIA HEIGHTS

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005