GENOA HEALTHCARE OF ILLINOIS LLC Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED PHARMACY

License Number

054017561

License Status

CHANGE OF OWNERSHIP

Business

Business Name

GENOA HEALTHCARE OF ILLINOIS LLC

Original Issue Date

11/17/2010

Effective Date

02/07/2012

Expiration Date

03/31/2014

City

DECATUR

State

Zip

62523

County

MACON

Ever Disciplined

LastModifiedDate

02/09/2012