SHOPKO PHARMACY 2150

Business Entity
CHANGE OF OWNERSHIP

Pharmacist

LICENSED CONTROLLED PHARMACY SUBSTANCE

32*****93

CHANGE OF OWNERSHIP

Y

SHOPKO PHARMACY 2150

06/15/1998

06/15/1998

03/31/2006

SPRINGFIELD

IL

62704

SANGAMON

II III IV V

N

05/11/2006