KENNETH WAYNE FISH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153942

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

WAYNE

Last Name

FISH

Business Name

KENNETH WAYNE FISH

Original Issue Date

04/06/2004

Effective Date

04/06/2004

Expiration Date

03/31/2006

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2006