MATT WOLLERT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049146510

License Status

NOT RENEWED

Business

First Name

MATT

Last Name

WOLLERT

Business Name

MATT WOLLERT

Original Issue Date

12/30/2002

Effective Date

12/30/2002

Expiration Date

03/31/2004

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005