GLEN A KETCHUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156716

License Status

NOT RENEWED

Business

First Name

GLEN

Middle

Last Name

KETCHUM

Business Name

GLEN A KETCHUM

Original Issue Date

08/17/2004

Effective Date

01/27/2016

Expiration Date

03/31/2017

City

GALVA

State

Zip

61434

County

HENRY

Ever Disciplined

LastModifiedDate

05/10/2017