KMART PHARMACY 4048 Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED PHARMACY

License Number

054006813

License Status

CHANGE OF OWNERSHIP

Business

Business Name

KMART PHARMACY 4048

Original Issue Date

01/01/1997

Expiration Date

03/31/2004

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005

Case Number

2000000804

Action

Reprimand

Discipline Start Date

05/15/2001