License Verification

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WAL-MART STORES EAST, LP WAL-MART PHARMACY 10-1090

License Number: PH15360

Data As Of 11/22/2024

Profession
Pharmacy
License
PH15360
License Status
CLEAR/
Qualifications
Community Pharmacy
Schedule II & III
License Expiration Date
2/28/2025
License Original Issue Date
06/30/1997
Address of Record
6767 103RD ST
JACKSONVILLE, FL 32210
Discipline on File
No
Public Complaint
No
Address
6767 103rd Street
JACKSONVILLE, FL 32210
Name Relationship Profession License Effective Date
AGWUNOBI, JOHN Pharmacy Affiliate Pharmacy Affiliate 02/18/2013
BEAHM, PAUL Pharmacy Affiliate Pharmacy Affiliate 02/18/2013
CHAPMAN, GEORGE Pharmacy Affiliate Pharmacy Affiliate 02/18/2013
HILAND, SUSANNE M Pharmacy Affiliate Pharmacy Affiliate 01/20/2012
HUSSAIN, SAFIA RX DPT MGR/COR/POR Pharmacist 38907 03/26/2023
LEWIS, DIJUANA Pharmacy Affiliate Pharmacy Affiliate 02/18/2013

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 11/22/2024



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.