MICHAEL SCOTT ELLERBROEK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049141843

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

SCOTT

Last Name

ELLERBROEK

Business Name

MICHAEL SCOTT ELLERBROEK

Original Issue Date

04/12/2002

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007