SAMUEL WALDEN ROTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049289106

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

WALDEN

Last Name

ROTH

Business Name

SAMUEL WALDEN ROTH

Original Issue Date

12/23/2021

Effective Date

12/23/2021

Expiration Date

05/31/2022

City

SAINT CHARLES

State

Zip

60175

County

KANE

Ever Disciplined

LastModifiedDate

07/27/2022