DAVID EUGENE SHOUP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155043

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

EUGENE

Last Name

SHOUP

Business Name

DAVID EUGENE SHOUP

Original Issue Date

06/11/2004

Effective Date

06/11/2004

Expiration Date

03/31/2005

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005