CHARLES MICHAEL KOSTKA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049104413

License Status

NOT RENEWED

Business

First Name

CHARLES MICHAEL

Last Name

KOSTKA

Business Name

CHARLES MICHAEL KOSTKA

Original Issue Date

09/01/1993

Effective Date

09/01/1993

Expiration Date

03/31/1997

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005