MEDICARE PHARMACY Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED PHARMACY

License Number

054007692

License Status

CHANGE OF OWNERSHIP

Business

Business Name

MEDICARE PHARMACY

Original Issue Date

01/01/1997

Expiration Date

03/31/1990

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

10/17/2005