DANIEL KEVIN MORTENSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133686

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

KEVIN

Last Name

MORTENSEN

Business Name

DANIEL KEVIN MORTENSEN

Original Issue Date

11/21/2000

Effective Date

11/21/2000

Expiration Date

03/31/2004

City

BURLINGTON

State

Zip

53105

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/20/2005