SUSAN MARIE NIELSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049252259

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

MARIE

Last Name

NIELSEN

Business Name

SUSAN MARIE NIELSEN

Original Issue Date

08/09/2017

Effective Date

03/28/2018

Expiration Date

03/31/2019

City

POLO

State

Zip

61064

County

OGLE

Ever Disciplined

LastModifiedDate

07/15/2019