STACY LYNN BERGQUIST Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049188292

License Status

NOT RENEWED

Business

First Name

STACY

Middle

LYNN

Last Name

BERGQUIST

Business Name

STACY LYNN BERGQUIST

Original Issue Date

11/18/2008

Effective Date

02/14/2012

Expiration Date

03/31/2013

City

DAVIS

State

Zip

61019

County

STEPHENSON

Ever Disciplined

LastModifiedDate

05/06/2013