TARGET STORE T1912 Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****03

License Status

CHANGE OF OWNERSHIP

Business

Business Name

TARGET STORE T1912

Original Issue Date

10/01/2004

Effective Date

03/11/2014

Expiration Date

03/31/2016

City

MUNDELEIN

State

Zip

60060

County

LAKE

Specialty/Qualifier

Retail Pharmacy

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2008