THE MEDICINE SHOPPE 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

THE MEDICINE SHOPPE

Original Issue Date

08/07/1990

Effective Date

08/07/1990

Expiration Date

03/31/2002

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/18/2005