MARY JANE WIETZEMA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049171590

License Status

NOT RENEWED

Business

First Name

MARY

Middle

JANE

Last Name

WIETZEMA

Business Name

MARY JANE WIETZEMA

Original Issue Date

09/25/2006

Effective Date

01/26/2015

Expiration Date

03/31/2016

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

05/20/2016