DYLAN LANE WAGONER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049223591

License Status

NOT RENEWED

Business

First Name

DYLAN

Middle

LANE

Last Name

WAGONER

Business Name

DYLAN LANE WAGONER

Original Issue Date

02/26/2014

Effective Date

02/26/2014

Expiration Date

03/31/2015

City

MULBERRY GROVE

State

Zip

62262

County

BOND

Ever Disciplined

LastModifiedDate

05/11/2015