TIFFANY C WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160581

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

WAGNER

Business Name

TIFFANY C WAGNER

Original Issue Date

04/25/2005

Effective Date

03/04/2009

Expiration Date

03/31/2010

City

CREST HILL

State

Zip

60403

County

WILL

Ever Disciplined

LastModifiedDate

05/04/2010