BENNIE L WAGNER Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049113230

License Status

INACTIVE

Business

First Name

BENNIE L

Last Name

WAGNER

Business Name

BENNIE L WAGNER

Original Issue Date

01/31/1996

Effective Date

02/24/2011

Expiration Date

03/31/2012

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

01/12/2012