SHANE D MADSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049177394

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

MADSEN

Business Name

SHANE D MADSEN

Original Issue Date

06/28/2007

Effective Date

03/29/2012

Expiration Date

03/31/2013

City

KENOSHA

State

Zip

53140

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/06/2013