MALORIE AUTUMN BERGE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049266521

License Status

NOT RENEWED

Business

First Name

MALORIE

Middle

AUTUMN

Last Name

BERGE

Business Name

MALORIE AUTUMN BERGE

Original Issue Date

07/08/2019

Effective Date

03/15/2021

Expiration Date

05/31/2022

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/27/2022