LISA ANN SIVERTSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049123996

License Status

NOT RENEWED

Business

First Name

LISA

Middle

ANN

Last Name

SIVERTSEN

Business Name

LISA ANN SIVERTSEN

Original Issue Date

12/02/1998

Effective Date

12/02/1998

Expiration Date

03/31/2000

City

RICHMOND

State

Zip

60071

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/21/2005