COREY JOSEPH FORTWENDEL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049264126

License Status

NOT RENEWED

Business

First Name

COREY

Middle

JOSEPH

Last Name

FORTWENDEL

Business Name

COREY JOSEPH FORTWENDEL

Original Issue Date

04/06/2019

Effective Date

04/06/2019

Expiration Date

09/30/2020

City

ROCKPORT

State

Zip

47635

Ever Disciplined

LastModifiedDate

01/08/2021