KEITH EDWARD GIBSON Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159593

License Status

INACTIVE

Business

First Name

KEITH

Middle

EDWARD

Last Name

GIBSON

Business Name

KEITH EDWARD GIBSON

Original Issue Date

03/17/2005

Effective Date

03/05/2009

Expiration Date

03/31/2010

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

01/12/2010