KEITH BREITHAUPT Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049071515

License Status

CANCELLED

Business

First Name

KEITH

Last Name

BREITHAUPT

Business Name

KEITH BREITHAUPT

Original Issue Date

07/13/1979

Effective Date

07/13/1979

Expiration Date

01/01/1997

City

SHATTUC

State

Zip

62283

County

CLINTON

Ever Disciplined

LastModifiedDate

10/17/2005