TRACIE M CARLSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049263262

License Status

NOT RENEWED

Business

First Name

TRACIE

Middle

Last Name

CARLSON

Business Name

TRACIE M CARLSON

Original Issue Date

02/11/2019

Effective Date

02/11/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/08/2021