KENNETH WAYNE FISH - Pharmacist License in Illinois | # 049153942

KENNETH WAYNE FISH

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153942

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006