ERIC MATTHEW BOMKAMP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049142832

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

MATTHEW

Last Name

BOMKAMP

Business Name

ERIC MATTHEW BOMKAMP

Original Issue Date

06/03/2002

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007