KEVIN DIETMAR PUETZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049218208

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

DIETMAR

Last Name

PUETZ

Business Name

KEVIN DIETMAR PUETZ

Original Issue Date

05/28/2013

Effective Date

05/28/2013

Expiration Date

03/31/2014

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/06/2014