BETH ANN GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159590

License Status

NOT RENEWED

Business

First Name

BETH

Middle

ANN

Last Name

GUSTAFSON

Business Name

BETH ANN GUSTAFSON

Original Issue Date

03/17/2005

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

GENOA CITY

State

Zip

53128

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/14/2007