Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Sep 19, 2011
License(s)
051.291567 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 106 WATTERS DR | Dwight, IL 60420-2200 | 815-584-2140 |
| LOCATION | 106 WATTERS DR | Dwight, IL 60420-2200 | 815-584-2140 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.