IVESCO HOLDINGS LLC Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED SUBSTANCE DRUG DIST

License Number

30*****02

License Status

CHANGE OF OWNERSHIP

Business

Business Name

IVESCO HOLDINGS LLC

Original Issue Date

12/07/2011

Effective Date

10/05/2012

Expiration Date

12/31/2014

City

IOWA FALLS

State

Zip

50126

County

IOWA

Specialty/Qualifier

DISTRIBUTOR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/19/2012