KEVIN WAYNE STORM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049070574

License Status

NOT RENEWED

Business

First Name

KEVIN WAYNE

Last Name

STORM

Business Name

KEVIN WAYNE STORM

Original Issue Date

01/12/1979

Effective Date

01/12/1979

Expiration Date

01/01/1997

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

10/17/2005