KENNETH DALE HAVENS - Pharmacist License in Illinois | # 049145128

KENNETH DALE HAVENS

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145128

License Status

NOT RENEWED

Business

N

First Name

KENNETH

Middle

DALE

Last Name

HAVENS

Business Name

KENNETH DALE HAVENS

Original Issue Date

10/08/2002

Effective Date

10/08/2002

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005