Fallesen, Mark A - (Pharmacy Technician)
Bolivar, MO 65613
License# : 2015003273 - Issued on : 2/3/2015
Doing Business As :
| Licensee Name: | Fallesen, Mark A |
| Profession Name: | Pharmacy Technician |
| Licensee Number: | 2015003273 |
| Expiration Date: | 5/31/2016 |
| Original Issue Date: | 2/3/2015 |
| Address: | |
| Address Con't: | |
| City, State Zip: | Bolivar, MO 65613 |
| County: | Polk |
| Practitioner DBA Name: | |
| Classification: |
| Current Discipline Status: | None |
Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists
