MANDY GLENN BERG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049249919

License Status

NOT RENEWED

Business

First Name

MANDY

Middle

GLENN

Last Name

BERG

Business Name

MANDY GLENN BERG

Original Issue Date

04/14/2017

Effective Date

03/06/2019

Expiration Date

09/30/2020

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

01/08/2021