DWAYNE KEITH DESHOTEL II Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049193070

License Status

NOT RENEWED

Business

First Name

DWAYNE

Middle

KEITH

Last Name

DESHOTEL

Suffix

Business Name

DWAYNE KEITH DESHOTEL II

Original Issue Date

07/17/2009

Effective Date

03/11/2019

Expiration Date

09/30/2020

City

BETHALTO

State

Zip

62010

County

MADISON

Ever Disciplined

LastModifiedDate

01/08/2021