MADISON ANN FORTNEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049285181

License Status

NOT RENEWED

Business

First Name

MADISON

Middle

ANN

Last Name

FORTNEY

Business Name

MADISON ANN FORTNEY

Original Issue Date

08/31/2021

Effective Date

08/31/2021

Expiration Date

05/31/2022

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Ever Disciplined

LastModifiedDate

07/27/2022