LEWIS M WAGGONER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051020139

License Status

NOT RENEWED

Business

First Name

LEWIS M

Last Name

WAGGONER

Business Name

LEWIS M WAGGONER

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

10/17/2005