MARK A WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049104687

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

WAGNER

Business Name

MARK A WAGNER

Original Issue Date

10/01/1993

Effective Date

10/01/1993

Expiration Date

03/31/2002

City

DEERFIELD

State

Zip

60015

County

LAKE

Ever Disciplined

LastModifiedDate

12/06/2005