SHANE MICHAEL CONZELMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049120811

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

MICHAEL

Last Name

CONZELMAN

Business Name

SHANE MICHAEL CONZELMAN

Original Issue Date

04/28/1998

Effective Date

03/23/2015

Expiration Date

03/31/2016

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/20/2016