LOREN EDWARD LEISEBERG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029200

License Status

NOT RENEWED

Business

First Name

LOREN EDWARD

Last Name

LEISEBERG

Business Name

LOREN EDWARD LEISEBERG

Original Issue Date

08/05/1972

Effective Date

01/04/2020

Expiration Date

07/31/2022

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/14/2022