PHYLLIS A WIEDNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049137091

License Status

NOT RENEWED

Business

First Name

PHYLLIS

Middle

Last Name

WIEDNER

Business Name

PHYLLIS A WIEDNER

Original Issue Date

07/03/2001

Effective Date

02/28/2011

Expiration Date

03/31/2012

City

PONTOON BEACH

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

05/07/2012