PEGGY JANE GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148020

License Status

NOT RENEWED

Business

First Name

PEGGY

Middle

JANE

Last Name

GUSTAFSON

Business Name

PEGGY JANE GUSTAFSON

Original Issue Date

04/16/2003

Effective Date

04/16/2003

Expiration Date

03/31/2004

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/20/2005