KEITH W GRONEWOLD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049066257

License Status

NOT RENEWED

Business

First Name

KEITH W

Last Name

GRONEWOLD

Business Name

KEITH W GRONEWOLD

Original Issue Date

10/15/1976

Effective Date

10/15/1976

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005