DAVID EUGENE SHOUP - Pharmacist License in Illinois | # 049155043

DAVID EUGENE SHOUP

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155043

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005