ADAM DAVID WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161452

License Status

NOT RENEWED

Business

First Name

ADAM

Middle

DAVID

Last Name

WAGNER

Business Name

ADAM DAVID WAGNER

Original Issue Date

06/03/2005

Effective Date

03/05/2018

Expiration Date

03/31/2019

City

PLAINFIELD

State

Zip

60585

County

WILL

Ever Disciplined

LastModifiedDate

07/15/2019