MARK A SEIBOLD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049167378

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

SEIBOLD

Business Name

MARK A SEIBOLD

Original Issue Date

04/06/2006

Effective Date

01/22/2010

Expiration Date

03/31/2011

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/12/2011