KENNETH DALE HAVENS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145128

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005