Pharmacist
LICENSED CONTROLLED SUBSTANCE DRUG DIST
30*****41
NOT RENEWED
Y
MCKESSON DRUG COMPANY
10/16/1992
10/16/1992
12/31/1996
ST PETERS
MO
63376
MISSOURI
Teaching Institution
Y
10/16/2005
2003003503
Fine
09/22/2004
Practiced in Illinois without a license for approximately five years.