PETER B FOURNESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051290295

License Status

NOT RENEWED

Business

First Name

PETER

Middle

Last Name

FOURNESS

Business Name

PETER B FOURNESS

Original Issue Date

12/06/2004

Effective Date

01/17/2012

Expiration Date

03/31/2014

City

EDGERTON

State

Zip

53534

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/06/2014