BRUCE DAVID LONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029836

License Status

NOT RENEWED

Business

First Name

BRUCE DAVID

Last Name

LONG

Business Name

BRUCE DAVID LONG

Original Issue Date

01/02/1974

Effective Date

01/02/1974

Expiration Date

01/01/1997

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005