TIMOTHY MARK WIETLISPACH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162188

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

MARK

Last Name

WIETLISPACH

Business Name

TIMOTHY MARK WIETLISPACH

Original Issue Date

07/12/2005

Effective Date

07/12/2005

Expiration Date

03/31/2006

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/11/2006