DALTON P DIECKOW Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051303137

License Status

ACTIVE

Business

First Name

DALTON

Middle

Last Name

DIECKOW

Prefix

Business Name

DALTON P DIECKOW

Original Issue Date

07/13/2020

Effective Date

03/02/2026

Expiration Date

03/31/2028

City

CANTON

State

Zip

61520

County

FULTON

Ever Disciplined

LastModifiedDate

03/02/2026