DERECK W WENTWORTH Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051286459

License Status

INACTIVE

Business

First Name

DERECK

Middle

Last Name

WENTWORTH

Prefix

Business Name

DERECK W WENTWORTH

Original Issue Date

02/04/1998

Effective Date

03/24/2022

Expiration Date

03/31/2024

City

NIOTA

State

Zip

37826

Ever Disciplined

LastModifiedDate

01/06/2024