PRIYATMA WIRTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049150169

License Status

NOT RENEWED

Business

First Name

PRIYATMA

Last Name

WIRTH

Business Name

PRIYATMA WIRTH

Original Issue Date

08/21/2003

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

RIVERSIDE

State

Zip

60546

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008