KIVONTAY ISAIAH SHAW Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049291847

License Status

NOT RENEWED

Business

First Name

KIVONTAY

Middle

ISAIAH

Last Name

SHAW

Business Name

KIVONTAY ISAIAH SHAW

Original Issue Date

04/06/2022

Effective Date

04/06/2022

Expiration Date

03/31/2023

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

09/07/2023