FALLON P HAGEN Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049197610

License Status

INACTIVE

Business

First Name

FALLON

Middle

Last Name

HAGEN

Prefix

Business Name

FALLON P HAGEN

Original Issue Date

04/01/2010

Effective Date

04/01/2010

Expiration Date

03/31/2011

City

MADISON

State

Zip

53705

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/05/2011