MATTHEW T WICKENHAUSER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049213063

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

WICKENHAUSER

Prefix

Business Name

MATTHEW T WICKENHAUSER

Original Issue Date

08/24/2012

Effective Date

02/13/2020

Expiration Date

03/31/2021

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

07/20/2021