RENA ANN WIDBOOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149500

License Status

NOT RENEWED

Business

First Name

RENA

Middle

ANN

Last Name

WIDBOOM

Business Name

RENA ANN WIDBOOM

Original Issue Date

07/15/2003

Effective Date

07/15/2003

Expiration Date

03/31/2005

City

BLAINE

State

Zip

55434

County

MINNESOTA

Ever Disciplined

LastModifiedDate

10/20/2005