KEITH W MERVIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049099576

License Status

NOT RENEWED

Business

First Name

KEITH W

Last Name

MERVIS

Business Name

KEITH W MERVIS

Original Issue Date

03/04/1992

Effective Date

03/04/1992

Expiration Date

03/31/1994

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005