MATTHEW RUSSELL WILDMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114591

License Status

NOT RENEWED

Business

First Name

MATTHEW RUSSELL

Last Name

WILDMAN

Business Name

MATTHEW RUSSELL WILDMAN

Original Issue Date

07/10/1996

Effective Date

07/10/1996

Expiration Date

03/31/1998

City

CERRO GORDO

State

Zip

61818

County

PIATT

Ever Disciplined

LastModifiedDate

10/17/2005