AMY BREITZKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158564

License Status

NOT RENEWED

Business

First Name

AMY

Last Name

BREITZKE

Business Name

AMY BREITZKE

Original Issue Date

12/22/2004

Effective Date

12/22/2004

Expiration Date

03/31/2006

City

VALPARAISO

State

Zip

46385

Ever Disciplined

LastModifiedDate

05/11/2006