THE MEDICINE SHOPPE HME and Services Provider License verification

Business Entity

NOT RENEWED

License Type

HME and Services Provider

Description

HOME MEDICAL EQUIPMENT AND SERVICES PROVIDER

License Number

203000745

License Status

NOT RENEWED

Business

Business Name

THE MEDICINE SHOPPE

Original Issue Date

11/08/2005

Effective Date

01/19/2006

Expiration Date

03/31/2009

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

05/06/2009