MATTHEW D LIESEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131867

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

LIESEN

Business Name

MATTHEW D LIESEN

Original Issue Date

07/28/2000

Effective Date

07/28/2000

Expiration Date

03/31/2002

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

12/06/2005