SUSAN K WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049101920

License Status

NOT RENEWED

Business

First Name

SUSAN K

Last Name

WAGNER

Business Name

SUSAN K WAGNER

Original Issue Date

12/07/1992

Effective Date

01/24/2017

Expiration Date

03/31/2018

City

CRESTWOOD

State

Zip

60445

County

COOK

Ever Disciplined

LastModifiedDate

06/19/2018