STACY DAWN NORDBROCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049117322

License Status

NOT RENEWED

Business

First Name

STACY

Middle

DAWN

Last Name

NORDBROCK

Business Name

STACY DAWN NORDBROCK

Original Issue Date

04/21/1997

Effective Date

04/21/1997

Expiration Date

03/31/2004

City

ROUND LAKE

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

10/20/2005