LICE ILL DEPT OF STATE PO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

OTHER CONTROLLED SUBSTANCE

License Number

097000260

License Status

NOT RENEWED

Business

Business Name

LICE ILL DEPT OF STATE PO

Original Issue Date

01/01/1997

Expiration Date

12/31/1992

City

DESOTO

State

County

JACKSON

Ever Disciplined

LastModifiedDate

10/18/2005