SOUTHERN ILLINOIS UNIVERSITY CARBONDALE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

OTHER CONTROLLED SUBSTANCE

License Number

097002145

License Status

NOT RENEWED

Business

Business Name

SOUTHERN ILLINOIS UNIVERSITY CARBONDALE

Original Issue Date

06/22/2016

Effective Date

02/15/2019

Expiration Date

12/31/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

OTHER

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

03/11/2021