DEKALB CLINIC PHARMACY Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****58

License Status

CHANGE OF OWNERSHIP

Business

Business Name

DEKALB CLINIC PHARMACY

Original Issue Date

01/01/1997

Expiration Date

03/31/2000

City

DEKALB

State

Zip

60115

County

DEKALB

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/18/2005