GENOA HEALTHCARE OF ILLINOIS LLC 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

GENOA HEALTHCARE OF ILLINOIS LLC

Original Issue Date

07/16/2013

Effective Date

01/15/2014

Expiration Date

03/31/2016

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/11/2013