BRICE ALAN WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049262637

License Status

NOT RENEWED

Business

First Name

BRICE

Middle

ALAN

Last Name

WAGNER

Business Name

BRICE ALAN WAGNER

Original Issue Date

01/09/2019

Effective Date

01/09/2019

Expiration Date

09/30/2020

City

HERSCHER

State

Zip

60941

County

KANKAKEE

Ever Disciplined

LastModifiedDate

01/08/2021