DANE R LEIST Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049176399

License Status

NOT RENEWED

Business

First Name

DANE

Middle

Last Name

LEIST

Business Name

DANE R LEIST

Original Issue Date

05/17/2007

Effective Date

01/25/2010

Expiration Date

03/31/2011

City

STURGEON BAY

State

Zip

54235

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/12/2011