KENNETH WAYNE FORD Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051032653

License Status

INACTIVE

Business

First Name

KENNETH WAYNE

Last Name

FORD

Business Name

KENNETH WAYNE FORD

Original Issue Date

05/14/1979

Effective Date

05/14/1979

Expiration Date

03/31/1990

City

LACROSSE

State

Zip

54601

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005