BRYAN T MIKLEVITZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161790

License Status

NOT RENEWED

Business

First Name

BRYAN

Middle

Last Name

MIKLEVITZ

Business Name

BRYAN T MIKLEVITZ

Original Issue Date

06/20/2005

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

EDWARDSVILLE

State

Zip

62025

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

05/14/2007