DIERBERGS GREEN MOUNT CROSSING Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****83

License Status

CHANGE OF OWNERSHIP

Business

Business Name

DIERBERGS GREEN MOUNT CROSSING

Original Issue Date

03/31/2003

Effective Date

03/03/2020

Expiration Date

03/31/2022

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

Retail Pharmacy

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/18/2020