DANIEL LYLE PETERSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143748

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

LYLE

Last Name

PETERSEN

Business Name

DANIEL LYLE PETERSEN

Original Issue Date

07/18/2002

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

CHERRY VALLEY

State

Zip

61016

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2008