SMITH DRUG STORE Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****05

License Status

CHANGE OF OWNERSHIP

Business

Business Name

SMITH DRUG STORE

Original Issue Date

01/01/1997

Effective Date

02/08/2006

Expiration Date

03/31/2008

City

PEORIA HEIGHTS

State

Zip

61616

County

PEORIA

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/16/2006