NISSA RAE DAHL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049186900

License Status

NOT RENEWED

Business

First Name

NISSA

Middle

RAE

Last Name

DAHL

Business Name

NISSA RAE DAHL

Original Issue Date

09/09/2008

Effective Date

03/08/2012

Expiration Date

03/31/2013

City

NEW BERLIN

State

Zip

53151

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/06/2013