ROBERTA A DIERCKS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049098146

License Status

NOT RENEWED

Business

First Name

ROBERTA A

Last Name

DIERCKS

Business Name

ROBERTA A DIERCKS

Original Issue Date

09/24/1991

Effective Date

09/24/1991

Expiration Date

03/31/1997

City

CHESTER

State

Zip

62233

County

RANDOLPH

Ever Disciplined

LastModifiedDate

10/17/2005