DAVID A NISSEN Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051286411

License Status

INACTIVE

Business

First Name

DAVID

Middle

Last Name

NISSEN

Business Name

DAVID A NISSEN

Original Issue Date

12/11/1997

Effective Date

03/31/2004

Expiration Date

03/31/2006

City

SAINT LOUIS

State

Zip

63116

Ever Disciplined

LastModifiedDate

01/18/2006