MOLLYANN K WAGONER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049195234

License Status

NOT RENEWED

Business

First Name

MOLLYANN

Middle

Last Name

WAGONER

Business Name

MOLLYANN K WAGONER

Original Issue Date

11/09/2009

Effective Date

03/30/2010

Expiration Date

03/31/2011

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

05/12/2011