KEITH KEVIN GODDARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049064653

License Status

NOT RENEWED

Business

First Name

KEITH KEVIN

Last Name

GODDARD

Business Name

KEITH KEVIN GODDARD

Original Issue Date

01/02/1976

Effective Date

01/02/1976

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005