ALYCE GODSHALL FATH Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051021992

License Status

INACTIVE

Business

First Name

ALYCE GODSHALL

Last Name

FATH

Business Name

ALYCE GODSHALL FATH

Original Issue Date

01/01/1997

Expiration Date

03/31/1990

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005