KEITH RUSSELL GROFF Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160909

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

RUSSELL

Last Name

GROFF

Business Name

KEITH RUSSELL GROFF

Original Issue Date

05/09/2005

Effective Date

01/30/2019

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/08/2021