PAUL DOUGLAS FOG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051033167

License Status

NOT RENEWED

Business

First Name

PAUL DOUGLAS

Last Name

FOG

Business Name

PAUL DOUGLAS FOG

Original Issue Date

05/01/1980

Effective Date

05/01/1980

Expiration Date

03/31/1990

City

KANSAS CITY

State

Zip

64138

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/17/2005