MIMI J WAGNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051039555

License Status

NOT RENEWED

Business

First Name

MIMI J

Last Name

WAGNER

Business Name

MIMI J WAGNER

Original Issue Date

10/14/1993

Effective Date

02/28/2014

Expiration Date

03/31/2016

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

05/20/2016