KENNETH ROBERT WELLER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157110

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

ROBERT

Last Name

WELLER

Business Name

KENNETH ROBERT WELLER

Original Issue Date

09/03/2004

Effective Date

03/17/2011

Expiration Date

03/31/2012

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/07/2012