TIMOTHY MICHAEL CARLSTROM Pharmacist License verification

TIMOTHY MICHAEL CARLSTROM

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153865

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

MICHAEL

Last Name

CARLSTROM

Business Name

TIMOTHY MICHAEL CARLSTROM

Original Issue Date

03/23/2004

Effective Date

05/04/2012

Expiration Date

03/31/2013

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/27/2014

Case Number

2013002372

Action

Refuse To Renew

Discipline Start Date

03/18/2014

Discipline Reason

due to his termination from employment at Walgreens Store for diversion of controlled substances and due to a guilty plea to Class A misdemeanor theft of controlled substances.