LORI SUE EWALD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122056

License Status

NOT RENEWED

Business

First Name

LORI

Middle

SUE

Last Name

EWALD

Business Name

LORI SUE EWALD

Original Issue Date

07/22/1998

Effective Date

07/22/1998

Expiration Date

03/31/2001

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/21/2005