MICHAEL L WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051032011

License Status

NOT RENEWED

Business

First Name

MICHAEL L

Last Name

WAGNER

Business Name

MICHAEL L WAGNER

Original Issue Date

03/09/1978

Effective Date

03/09/1978

Expiration Date

03/31/1998

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005