MATTHEW R DIERKS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049168567

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

DIERKS

Business Name

MATTHEW R DIERKS

Original Issue Date

05/10/2006

Effective Date

05/10/2006

Expiration Date

03/31/2007

City

SCHERERVILLE

State

Zip

46375

County

LAKE

Ever Disciplined

LastModifiedDate

05/14/2007