NICOLE F SANDBERG Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051290735

License Status

INACTIVE

Business

First Name

NICOLE

Middle

Last Name

SANDBERG

Business Name

NICOLE F SANDBERG

Original Issue Date

08/23/2005

Effective Date

04/01/2010

Expiration Date

03/31/2012

City

PRAIRIE DU SAC

State

Zip

53578

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/12/2012