DIANA F WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049147851

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

Last Name

WAGNER

Business Name

DIANA F WAGNER

Original Issue Date

04/03/2003

Effective Date

03/02/2009

Expiration Date

03/31/2010

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010