KEITH D WIEGAND Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049108219

License Status

NOT RENEWED

Business

First Name

KEITH D

Last Name

WIEGAND

Business Name

KEITH D WIEGAND

Original Issue Date

09/23/1994

Effective Date

09/23/1994

Expiration Date

03/31/1996

City

POLO

State

Zip

61064

County

OGLE

Ever Disciplined

LastModifiedDate

10/17/2005