JACLYN S WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049174037

License Status

NOT RENEWED

Business

First Name

JACLYN

Middle

Last Name

WAGNER

Business Name

JACLYN S WAGNER

Original Issue Date

01/31/2007

Effective Date

02/08/2012

Expiration Date

03/31/2013

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/06/2013