ALYSA MICHELLE WAGNER - Pharmacist License in Illinois | # 049137049

ALYSA MICHELLE WAGNER

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049137049

License Status

NOT RENEWED

Business

N

First Name

ALYSA

Middle

MICHELLE

Last Name

WAGNER

Business Name

ALYSA MICHELLE WAGNER

Original Issue Date

07/03/2001

Effective Date

01/09/2007

Expiration Date

03/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

05/02/2008