KMART STORES OF IL LLC 9331 Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****32

License Status

NOT RENEWED

Business

Business Name

KMART STORES OF IL LLC 9331

Original Issue Date

03/08/2004

Effective Date

03/12/2012

Expiration Date

03/31/2014

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Specialty/Qualifier

Retail Pharmacy

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2014