KEITH T HOLDER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157501

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

Last Name

HOLDER

Business Name

KEITH T HOLDER

Original Issue Date

10/19/2004

Effective Date

10/19/2004

Expiration Date

03/31/2005

City

STREAMWOOD

State

Zip

60107

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005