TRACI L BERGMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049109263

License Status

NOT RENEWED

Business

First Name

TRACI L

Last Name

BERGMAN

Business Name

TRACI L BERGMAN

Original Issue Date

01/12/1995

Effective Date

01/12/1995

Expiration Date

03/31/2005

City

LAKE IN THE HILLS

State

Zip

60156

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/20/2005