MARK EDWARD BERG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049175437

License Status

NOT RENEWED

Business

First Name

MARK

Middle

EDWARD

Last Name

BERG

Business Name

MARK EDWARD BERG

Original Issue Date

04/09/2007

Effective Date

01/12/2010

Expiration Date

03/31/2011

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/12/2011