KEMBA K WAGNER - Pharmacist License in Illinois | # 049142172

KEMBA K WAGNER

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049142172

License Status

NOT RENEWED

Business

N

First Name

KEMBA

Middle

K

Last Name

WAGNER

Business Name

KEMBA K WAGNER

Original Issue Date

05/02/2002

Effective Date

05/02/2002

Expiration Date

03/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005