NATHAN R BROCKMEIER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145300

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

Last Name

BROCKMEIER

Business Name

NATHAN R BROCKMEIER

Original Issue Date

10/15/2002

Effective Date

10/15/2002

Expiration Date

03/31/2004

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

10/20/2005