NICK LEE WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049165970

License Status

NOT RENEWED

Business

First Name

NICK

Middle

LEE

Last Name

WAGNER

Business Name

NICK LEE WAGNER

Original Issue Date

01/06/2006

Effective Date

01/06/2006

Expiration Date

03/31/2007

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

05/14/2007