STEPHANIE A BERGMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049130554

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

BERGMAN

Business Name

STEPHANIE A BERGMAN

Original Issue Date

04/14/2000

Effective Date

04/14/2000

Expiration Date

03/31/2001

City

KEWANEE

State

Zip

61443

County

HENRY

Ever Disciplined

LastModifiedDate

10/21/2005