Credential Summary - Renewal Requirements

Credential Summary for 9007-42
Name: GOOD VALUE PHARMACY MEDCARE WEST
Credential Type: PHARMACY (42)
Credential Number: 9007-42
Location: KENOSHA, WI
License Type: regular
Status License is current (Active)
Eligible To Practice: credential license is current
First Fee Received: YES

DetailsRequirementsPaymentsOrdersRelationships
Renewal requirements for the year: 2022
Requirement Code Complied? Complied Date
SIG requirement complied 06/13/2022
FEE requirement complied 05/30/2022


Requirement Code Description

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