THE MEDICINE SHOPPE 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

THE MEDICINE SHOPPE

Original Issue Date

01/10/1989

Effective Date

01/10/1989

Expiration Date

03/31/2000

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/18/2005