SAMANTHA RAE WAGNER - Pharmacist License in Illinois | # 049221530

SAMANTHA RAE WAGNER

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049221530

License Status

NOT RENEWED

Business

N

First Name

SAMANTHA

Middle

RAE

Last Name

WAGNER

Business Name

SAMANTHA RAE WAGNER

Original Issue Date

10/21/2013

Effective Date

02/14/2017

Expiration Date

03/31/2018

State

IL

Ever Disciplined

N

LastModifiedDate

06/19/2018