ROBERT JOHN BERGSTROM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049132606

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

JOHN

Last Name

BERGSTROM

Business Name

ROBERT JOHN BERGSTROM

Original Issue Date

09/11/2000

Effective Date

09/11/2000

Expiration Date

03/31/2005

City

ALPHA

State

Zip

61413

County

HENRY

Ever Disciplined

LastModifiedDate

10/20/2005