DOUGLAS J DE BROUX Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051039506

License Status

INACTIVE

Business

First Name

DOUGLAS J

Last Name

DE BROUX

Business Name

DOUGLAS J DE BROUX

Original Issue Date

10/08/1993

Effective Date

02/14/2012

Expiration Date

03/31/2014

City

LODI

State

Zip

53555

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/09/2014