KRISTIE NICOLE WILDER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157028

License Status

NOT RENEWED

Business

First Name

KRISTIE

Middle

NICOLE

Last Name

WILDER

Business Name

KRISTIE NICOLE WILDER

Original Issue Date

09/01/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

DECATUR

State

Zip

62522

County

MACON

Ever Disciplined

LastModifiedDate

05/02/2008