NICHOLAS MATTHEW PETERSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049183117

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

MATTHEW

Last Name

PETERSEN

Business Name

NICHOLAS MATTHEW PETERSEN

Original Issue Date

03/26/2008

Effective Date

03/26/2008

Expiration Date

03/31/2009

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

05/06/2009