MATTHEW J HOLTAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049136206

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

HOLTAN

Business Name

MATTHEW J HOLTAN

Original Issue Date

05/04/2001

Effective Date

05/04/2001

Expiration Date

03/31/2005

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005