SHOPKO PHARMACY #2173

Business Entity
CHANGE OF OWNERSHIP

Pharmacist

LICENSED CONTROLLED PHARMACY SUBSTANCE

32*****33

CHANGE OF OWNERSHIP

Y

SHOPKO PHARMACY #2173

03/16/2000

03/16/2000

03/31/2006

EAST PEORIA

IL

61602

TAZEWELL

II III IV V

N

10/18/2005