Missouri Pharmacists: 10/14/15

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Allan Hinkle, MIC

Lockbourne, MO 43137

License# : 2014041630 - Issued on : 11/26/2014

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2014041630
Expiration Date:	10/31/2015
Original Issue Date:	11/26/2014
Address:	Allan Hinkle, MIC
Address Con't:	6301 LaSalle Dr
City, State Zip:	Lockbourne, OH 43137
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists

American Integrative Pharmacy LLC - Pharmacy

American Integrative Pharmacy LLC - (Pharmacy)

Zahra Sarajha, PIC

Lomita, MO 90717

License# : 2011010276 - Issued on : 4/13/2011

Doing Business As : American Integrative Pharmacy

Licensee Name:	American Integrative Pharmacy LLC
Profession Name:	Pharmacy
Licensee Number:	2011010276
Expiration Date:	10/31/2015
Original Issue Date:	4/13/2011
Address:	Zahra Sarajha, PIC
Address Con't:	1852 Lomita Blvd Ste 204
City, State Zip:	Lomita, CA 90717
County:	Unknown/Out of State
Practitioner DBA Name:	American Integrative Pharmacy
Classification:	Class A, D

Current Discipline Status:

None

Amgen USA Inc - Drug Distributor

Amgen USA Inc - (Drug Distributor)

Maria E Blanes Ibarra, MIC

Juncos, MO 00777

License# : 2012042788 - Issued on : 12/28/2012

Doing Business As : Amgen USA Inc

Licensee Name:	Amgen USA Inc
Profession Name:	Drug Distributor
Licensee Number:	2012042788
Expiration Date:	10/31/2015
Original Issue Date:	12/28/2012
Address:	Maria E Blanes Ibarra, MIC
Address Con't:	Rd 31, Km. 24.6, Barrio Ceiba Norte
City, State Zip:	Juncos, PR 00777
County:	Unknown/Out of State
Practitioner DBA Name:	Amgen USA Inc
Classification:	Out of State Wholesale

Current Discipline Status:

None

Amgen Inc. - Drug Distributor

Amgen Inc. - (Drug Distributor)

Stephen Flores, MIC

Thousand Oaks, MO 91320

License# : 2010005804 - Issued on : 2/19/2010

Doing Business As : Amgen Inc.

Licensee Name:	Amgen Inc.
Profession Name:	Drug Distributor
Licensee Number:	2010005804
Expiration Date:	10/31/2015
Original Issue Date:	2/19/2010
Address:	Stephen Flores, MIC
Address Con't:	One Amgen Center Dr.
City, State Zip:	Thousand Oaks, CA 91320
County:	Unknown/Out of State
Practitioner DBA Name:	Amgen Inc.
Classification:	Out of State Wholesale

Current Discipline Status:

None

Ames, Chelsea Jae - Pharmacist

Ames, Chelsea Jae - (Pharmacist)

Ozark, MO 65721

License# : 2014027807 - Issued on : 8/6/2014

Doing Business As :

Licensee Name:	Ames, Chelsea Jae
Profession Name:	Pharmacist
Licensee Number:	2014027807
Expiration Date:	10/31/2016
Original Issue Date:	8/6/2014
Address:
Address Con't:
City, State Zip:	Ozark, MO 65721
County:	Christian
Practitioner DBA Name:
Classification:

Current Discipline Status:

None

Certification Type:	Effective Date:	Expiration Date:
NOI - Administration By Protocol	9/27/2014	9/26/2015
NOI - Administration By Medical Prescription Order	9/27/2014	9/26/2015

Ames, Amber Nichole - Pharmacy Technician

Ames, Amber Nichole - (Pharmacy Technician)

Webb City, MO 64870

License# : 2005036477 - Issued on : 11/7/2005

Doing Business As :

Licensee Name:	Ames, Amber Nichole
Profession Name:	Pharmacy Technician
Licensee Number:	2005036477
Expiration Date:	5/31/2016
Original Issue Date:	11/7/2005
Address:
Address Con't:
City, State Zip:	Webb City, MO 64870
County:	Jasper
Practitioner DBA Name:
Classification:

Current Discipline Status:

None

Amerson, April D - Pharmacy Technician

Amerson, April D - (Pharmacy Technician)

Saint Louis, MO 631391135

License# : 2011023404 - Issued on : 7/20/2011

Doing Business As :

Licensee Name:	Amerson, April D
Profession Name:	Pharmacy Technician
Licensee Number:	2011023404
Expiration Date:	5/31/2016
Original Issue Date:	7/20/2011
Address:
Address Con't:
City, State Zip:	Saint Louis, MO 631391135
County:	St. Louis City
Practitioner DBA Name:
Classification:

Current Discipline Status:

None

Amerita Inc - Pharmacy

Amerita Inc - (Pharmacy)

Ricky E Burgess, PIC

Tulsa, MO 74146

License# : 2013000703 - Issued on : 1/8/2013

Doing Business As : Saffa Infusion Pharmacy

Licensee Name:	Amerita Inc
Profession Name:	Pharmacy
Licensee Number:	2013000703
Expiration Date:	10/31/2017
Original Issue Date:	1/8/2013
Address:	Ricky E Burgess, PIC
Address Con't:	12515 East 55th St
City, State Zip:	Tulsa, OK 74146
County:	Unknown/Out of State
Practitioner DBA Name:	Saffa Infusion Pharmacy
Classification:	Class H

Current Discipline Status:

None

AmerisourceBergen Holding Corporation - Pharmacy

AmerisourceBergen Holding Corporation - (Pharmacy)

Kenneth Webster, PIC

Rockville, MO 20850

License# : 2012014912 - Issued on : 5/16/2012

Doing Business As : TheraCom

Licensee Name:	AmerisourceBergen Holding Corporation
Profession Name:	Pharmacy
Licensee Number:	2012014912
Expiration Date:	10/31/2015
Original Issue Date:	5/16/2012
Address:	Kenneth Webster, PIC
Address Con't:	9717 Key West
City, State Zip:	Rockville, MD 20850
County:	Unknown/Out of State
Practitioner DBA Name:	TheraCom
Classification:	Class A

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Gregory Hickerson, MIC

Sugar Land, MO 77478

License# : 2006012389 - Issued on : 5/1/2006

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2006012389
Expiration Date:	10/31/2015
Original Issue Date:	5/1/2006
Address:	Gregory Hickerson, MIC
Address Con't:	12727 West Airport Blvd
City, State Zip:	Sugar Land, TX 77478
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Trenton Gregory Battersby, MIC

Denver, MO 80216

License# : 2002028650 - Issued on : 1/16/2003

Doing Business As : AmerisourceBergen Drug Cororation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2002028650
Expiration Date:	10/31/2015
Original Issue Date:	1/16/2003
Address:	Trenton Gregory Battersby, MIC
Address Con't:	501 W. 44th Ave
City, State Zip:	Denver, CO 80216
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Cororation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Michael L Garland, MIC

Phoenix, MO 85009

License# : 2002026542 - Issued on : 1/16/2003

Doing Business As : AmerisoureBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2002026542
Expiration Date:	10/31/2017
Original Issue Date:	1/16/2003
Address:	Michael L Garland, MIC
Address Con't:	1825 S. 43rd Ave, Ste B
City, State Zip:	Phoenix, AZ 85009
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisoureBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Gregory Earl Brown, MIC

Orlando, MO 32809

License# : 2001032982 - Issued on : 3/11/2002

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2001032982
Expiration Date:	10/31/2015
Original Issue Date:	3/11/2002
Address:	Gregory Earl Brown, MIC
Address Con't:	2100 Directors Row
City, State Zip:	Orlando, FL 32809
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Matthew Stine, MIC

Kansas City, MO 64153

License# : 2005017289 - Issued on : 6/8/2005

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2005017289
Expiration Date:	10/31/2017
Original Issue Date:	6/8/2005
Address:	Matthew Stine, MIC
Address Con't:	11200 North Congress
City, State Zip:	Kansas City, MO 64153
County:	Platte
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Wholesale Drug Distributor

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Dale Paakkonen, MIC

Romeoville, MO 60446

License# : 2005015250 - Issued on : 5/25/2005

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2005015250
Expiration Date:	10/31/2015
Original Issue Date:	5/25/2005
Address:	Dale Paakkonen, MIC
Address Con't:	1001 W Taylor Rd
City, State Zip:	Romeoville, IL 60446
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Frank DiCenso, MIC

Lockbourne, MO 43137

License# : 2004028337 - Issued on : 9/30/2004

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2004028337
Expiration Date:	10/31/2017
Original Issue Date:	9/30/2004
Address:	Frank DiCenso, MIC
Address Con't:	6305 LaSalle Dr
City, State Zip:	Lockbourne, OH 43137
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

John C Stavich, MIC

Corona, MO 92881

License# : 2004007384 - Issued on : 3/17/2004

Doing Business As : AmerisourceBergen Drug Company

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2004007384
Expiration Date:	10/31/2015
Original Issue Date:	3/17/2004
Address:	John C Stavich, MIC
Address Con't:	1851 California Avenue
City, State Zip:	Corona, CA 92881
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Company
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Glen Alcorn, MIC

Kent, MO 98032

License# : 2003028382 - Issued on : 11/17/2003

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2003028382
Expiration Date:	10/31/2017
Original Issue Date:	11/17/2003
Address:	Glen Alcorn, MIC
Address Con't:	19220 64th Ave South
City, State Zip:	Kent, WA 98032
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Shawn McGuire, MIC

Sacramento, MO 95834

License# : 2003022484 - Issued on : 9/9/2003

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2003022484
Expiration Date:	10/31/2015
Original Issue Date:	9/9/2003
Address:	Shawn McGuire, MIC
Address Con't:	1325 W Striker
City, State Zip:	Sacramento, CA 95834
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Tracy Terrien, MIC

Mansfield, MO 02048

License# : 2003006222 - Issued on : 3/18/2003

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2003006222
Expiration Date:	10/31/2017
Original Issue Date:	3/18/2003
Address:	Tracy Terrien, MIC
Address Con't:	101 Norfolk Street
City, State Zip:	Mansfield, MA 02048
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Michael Lee Irwin, MIC

Suwanee, MO 30024

License# : 2003004342 - Issued on : 3/25/2003

Doing Business As : AmerisourceBergen

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2003004342
Expiration Date:	10/31/2015
Original Issue Date:	3/25/2003
Address:	Michael Lee Irwin, MIC
Address Con't:	1085 N. Satellite Blvd
City, State Zip:	Suwanee, GA 30024
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corporation - Drug Distributor

AmerisourceBergen Drug Corporation - (Drug Distributor)

Dave P Ormsby, MIC

Williamston, MO 48895

License# : 2002030412 - Issued on : 1/16/2003

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corporation
Profession Name:	Drug Distributor
Licensee Number:	2002030412
Expiration Date:	10/31/2017
Original Issue Date:	1/16/2003
Address:	Dave P Ormsby, MIC
Address Con't:	One Industrial Park Drive
City, State Zip:	Williamston, MI 48895
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corpoartion - Drug Distributor

AmerisourceBergen Drug Corpoartion - (Drug Distributor)

William Licciardone, MIC

Salt Lake City, MO 84104

License# : 2002028654 - Issued on : 1/3/2003

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Drug Corpoartion
Profession Name:	Drug Distributor
Licensee Number:	2002028654
Expiration Date:	10/31/2017
Original Issue Date:	1/3/2003
Address:	William Licciardone, MIC
Address Con't:	1765 Fremont Drive
City, State Zip:	Salt Lake City, UT 84104
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corp - Drug Distributor

AmerisourceBergen Drug Corp - (Drug Distributor)

Tyson Moore, MIC

Bethlehem, MO 18017

License# : 2006013103 - Issued on : 5/10/2006

Doing Business As : AmerisourceBergen Drug Corp

Licensee Name:	AmerisourceBergen Drug Corp
Profession Name:	Drug Distributor
Licensee Number:	2006013103
Expiration Date:	10/31/2015
Original Issue Date:	5/10/2006
Address:	Tyson Moore, MIC
Address Con't:	5100 Jaindi Blvd
City, State Zip:	Bethlehem, PA 18017
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corp
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Corp - Drug Distributor

AmerisourceBergen Drug Corp - (Drug Distributor)

John Bridger Tatum, MIC

Roanoke, MO 76262

License# : 2005002742 - Issued on : 2/3/2005

Doing Business As : AmerisourceBergen Drug Corp

Licensee Name:	AmerisourceBergen Drug Corp
Profession Name:	Drug Distributor
Licensee Number:	2005002742
Expiration Date:	10/31/2015
Original Issue Date:	2/3/2005
Address:	John Bridger Tatum, MIC
Address Con't:	501 Patriot Parkway
City, State Zip:	Roanoke, TX 76262
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corp
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Drug Company - Drug Distributor

AmerisourceBergen Drug Company - (Drug Distributor)

Aaron Nadlicki, MIC

Glen Allen, MO 23059

License# : 2003030528 - Issued on : 12/15/2003

Doing Business As : AmerisourceBergen Drug Company

Licensee Name:	AmerisourceBergen Drug Company
Profession Name:	Drug Distributor
Licensee Number:	2003030528
Expiration Date:	10/31/2015
Original Issue Date:	12/15/2003
Address:	Aaron Nadlicki, MIC
Address Con't:	9900 J.E.B. Stuart Parkway
City, State Zip:	Glen Allen, VA 23059
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Company
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmerisourceBergen Corporation - Drug Distributor

AmerisourceBergen Corporation - (Drug Distributor)

James Brent Cook, MIC

Paducah, MO 42001

License# : 900027 - Issued on : 1/13/1992

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	AmerisourceBergen Corporation
Profession Name:	Drug Distributor
Licensee Number:	900027
Expiration Date:	10/31/2017
Original Issue Date:	1/13/1992
Address:	James Brent Cook, MIC
Address Con't:	322 North Third St.
City, State Zip:	Paducah, KY 42001
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None

AmeriSource Health Sevices Corporation - Drug Distributor

AmeriSource Health Sevices Corporation - (Drug Distributor)

Domenico Ciarico, MIC

Columbus, MO 43217

License# : 2001031933 - Issued on : 3/21/2002

Doing Business As : American Health Packaging

Licensee Name:	AmeriSource Health Sevices Corporation
Profession Name:	Drug Distributor
Licensee Number:	2001031933
Expiration Date:	10/31/2015
Original Issue Date:	3/21/2002
Address:	Domenico Ciarico, MIC
Address Con't:	2550 John Glenn Ave, Ste A
City, State Zip:	Columbus, OH 43217
County:	Unknown/Out of State
Practitioner DBA Name:	American Health Packaging
Classification:	Out of State Wholesale

Current Discipline Status:

None

Amerisource Corporation - Drug Distributor

Amerisource Corporation - (Drug Distributor)

Dawn Ewanika, MIC

Eden Prairie, MO 55344

License# : 900717 - Issued on : 3/10/1995

Doing Business As : AmerisourceBergen Drug Corporation

Licensee Name:	Amerisource Corporation
Profession Name:	Drug Distributor
Licensee Number:	900717
Expiration Date:	10/31/2015
Original Issue Date:	3/10/1995
Address:	Dawn Ewanika, MIC
Address Con't:	6810 Shady Oak Road
City, State Zip:	Eden Prairie, MN 55344
County:	Unknown/Out of State
Practitioner DBA Name:	AmerisourceBergen Drug Corporation
Classification:	Out of State Wholesale

Current Discipline Status:

None