KEITH D PETERSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051034317

License Status

NOT RENEWED

Business

First Name

KEITH D

Last Name

PETERSEN

Business Name

KEITH D PETERSEN

Original Issue Date

07/13/1982

Effective Date

03/16/2016

Expiration Date

03/31/2018

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

06/19/2018