ROBERT E WICKESBERG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

OTHER CONTROLLED SUBSTANCE

License Number

097001278

License Status

NOT RENEWED

Business

Business Name

ROBERT E WICKESBERG

Original Issue Date

12/23/2002

Effective Date

11/15/2012

Expiration Date

12/31/2014

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

02/11/2015