MICHAEL ANTHONY NICKLAS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049244859

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANTHONY

Last Name

NICKLAS

Business Name

MICHAEL ANTHONY NICKLAS

Original Issue Date

09/21/2016

Effective Date

04/12/2017

Expiration Date

03/31/2018

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

06/19/2018