DAVID KEITH BIVENS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057368

License Status

NOT RENEWED

Business

First Name

DAVID KEITH

Last Name

BIVENS

Business Name

DAVID KEITH BIVENS

Original Issue Date

02/18/1972

Effective Date

02/18/1972

Expiration Date

01/01/1997

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/17/2005