MARY ELLEN WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049113285

License Status

NOT RENEWED

Business

First Name

MARY ELLEN

Last Name

WAGNER

Business Name

MARY ELLEN WAGNER

Original Issue Date

02/01/1996

Effective Date

02/18/2020

Expiration Date

03/31/2021

City

MONTGOMERY

State

Zip

60538

County

KENDALL

Ever Disciplined

LastModifiedDate

07/20/2021