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Credential/License Summary for 5137

Name: BELOIT HEALTH SYSTEM PHARMACY
Profession: PHARMACY (42)
Credential/License Number: 5137-42
Location: BELOIT WI
Credential/License Type: regular
Status: License is current (Active)
Eligible To Practice: credential license is current

Details
Requirements
Payments
Orders
Relationships

Credential/License current through: 5/31/2026
Granted date: 3/2/1970
Multi-state: N/A
Orders: NONE
Specialties: NONE
Other Names: Beloit Memorial Hosp Phcy
Beloit Health Systems Hospital Pharmacy
Beloit Health System Pharmacy
Beloit Memorial Hosp Phcy
Beloit Memorial Hospital Phcy

Requirement Code Complied? Complied Date
Renewal Requirements for the year: 2022
FEE requirement complied 04/28/2022
SIG requirement complied 04/19/2022
Renewal Year Amount Paid Payment Received
2022 60 04/28/2022

No data found.

Individuals
Name Location Relationship Start Date
LOCKE, SHELLEY BELOIT WI MANAGING PHARMACIST 05/11/2018
Firms
Name Location Relationship Start Date

ATTENTION: If a renewal application including payment is received by the renew by date (or Credential/License current through date), the credential holder is eligible to practice while the credential renewal is being processed. The credential holder must respond to any requests for information during the renewal process. See Wis. Stat. ยง 227.51(2).

Requirement Code Description

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