MATTHEW J WAGNER - Pharmacist License in Illinois | # 049124783

MATTHEW J WAGNER

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124783

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

J

Last Name

WAGNER

Business Name

MATTHEW J WAGNER

Original Issue Date

02/23/1999

Effective Date

02/23/1999

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005