SOPHIA FASOLDT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049246752

License Status

NOT RENEWED

Business

First Name

SOPHIA

Last Name

FASOLDT

Business Name

SOPHIA FASOLDT

Original Issue Date

12/01/2016

Effective Date

12/01/2016

Expiration Date

03/31/2017

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/10/2017