BROOK MAE VAN HISE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049295720

License Status

NOT RENEWED

Business

First Name

BROOK

Middle

MAE

Last Name

VAN HISE

Business Name

BROOK MAE VAN HISE

Original Issue Date

09/09/2022

Effective Date

02/09/2024

Expiration Date

03/31/2025

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/09/2025