KEITH DAVID WILSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161356

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

DAVID

Last Name

WILSON

Business Name

KEITH DAVID WILSON

Original Issue Date

05/26/2005

Effective Date

02/27/2009

Expiration Date

03/31/2010

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

05/04/2010