KENNETH A PETERSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051021706

License Status

NOT RENEWED

Business

First Name

KENNETH A

Last Name

PETERSON

Business Name

KENNETH A PETERSON

Original Issue Date

01/01/1997

Expiration Date

03/31/2004

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/06/2005