JEFFREY MATTHEW FANALE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122464

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

MATTHEW

Last Name

FANALE

Business Name

JEFFREY MATTHEW FANALE

Original Issue Date

08/14/1998

Effective Date

08/14/1998

Expiration Date

03/31/2002

City

KENOSHA

State

Zip

53142

County

WISCONSIN

Ever Disciplined

LastModifiedDate

12/06/2005