DAVID GLENN MIKUS Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029104

License Status

INACTIVE

Business

First Name

DAVID GLENN

Last Name

MIKUS

Business Name

DAVID GLENN MIKUS

Original Issue Date

04/26/1972

Effective Date

02/09/2016

Expiration Date

03/31/2018

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/12/2018