KEN A WITT PHD Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

OTHER CONTROLLED SUBSTANCE

License Number

097001512

License Status

ACTIVE

Business

First Name

KEN

Middle

Last Name

WITT

Suffix

PHD

Business Name

KEN A WITT PHD

Original Issue Date

04/27/2006

Effective Date

09/30/2024

Expiration Date

12/31/2026

City

EDWARDSVILLE

State

Zip

62026

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024