KALEB BLAINE SHUMARD DMD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049269672

License Status

NOT RENEWED

Business

Title

DMD

First Name

KALEB

Middle

BLAINE

Last Name

SHUMARD

Business Name

KALEB BLAINE SHUMARD DMD

Original Issue Date

12/04/2019

Effective Date

03/16/2021

Expiration Date

05/31/2022

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

07/27/2022