MORTON VILLAGE PHARMACY Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****74

License Status

CHANGE OF OWNERSHIP

Business

Business Name

MORTON VILLAGE PHARMACY

Original Issue Date

01/01/1997

Expiration Date

03/31/2004

City

MORTON

State

Zip

61550

County

TAZEWELL

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/18/2005