KEITH L STAPLETON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139269

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

Last Name

STAPLETON

Business Name

KEITH L STAPLETON

Original Issue Date

11/19/2001

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

NORRIDGE

State

Zip

60706

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2007

Case Number

2005006433

Action

Revocation

Discipline Start Date

01/03/2007

Discipline Reason

Diverted Sufentanil, a Schedule II controlled substance, without authorization from his pharmacy employer.