MATTHEW J WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124783

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

WAGNER

Business Name

MATTHEW J WAGNER

Original Issue Date

02/23/1999

Effective Date

02/23/1999

Expiration Date

03/31/2004

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005