MICHAEL JOHN PETERSEN Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029711

License Status

INACTIVE

Business

First Name

MICHAEL JOHN

Last Name

PETERSEN

Business Name

MICHAEL JOHN PETERSEN

Original Issue Date

08/02/1973

Effective Date

08/02/1973

Expiration Date

03/31/1988

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/17/2005