SHOPKO PHARMACY 2174 Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED PHARMACY

License Number

054015785

License Status

CHANGE OF OWNERSHIP

Business

Business Name

SHOPKO PHARMACY 2174

Original Issue Date

03/10/2006

Effective Date

03/10/2006

Expiration Date

03/31/2008

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

02/27/2006