GENOA HEALTHCARE OF ILLINOIS LLC Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****72

License Status

CHANGE OF OWNERSHIP

Business

Business Name

GENOA HEALTHCARE OF ILLINOIS LLC

Original Issue Date

03/27/2012

Effective Date

01/14/2014

Expiration Date

03/31/2016

City

ELGIN

State

Zip

60123

County

KANE

Specialty/Qualifier

RETAIL PHARMACY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/09/2012