SHY LYNN WAGONER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049125874

License Status

NOT RENEWED

Business

First Name

SHY

Middle

LYNN

Last Name

WAGONER

Business Name

SHY LYNN WAGONER

Original Issue Date

05/12/1999

Effective Date

05/12/1999

Expiration Date

03/31/2005

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005