DEKALB CLINIC CHARTERED Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****79

License Status

CHANGE OF OWNERSHIP

Business

Business Name

DEKALB CLINIC CHARTERED

Original Issue Date

02/08/2000

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

DEKALB

State

Zip

60115

County

DEKALB

Specialty/Qualifier

Retail Pharmacy

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/20/2008