KELLY JEAN FAGERSTROM Funeral Director and Embalmer License verification

Business Entity

CANCELLED

License Type

Funeral Director and Embalmer

Description

LICENSED FUNERAL DIRECTOR AND EMBALMER INTERN

License Number

033013242

License Status

CANCELLED

Business

First Name

KELLY

Middle

JEAN

Last Name

FAGERSTROM

Business Name

KELLY JEAN FAGERSTROM

Original Issue Date

05/14/2021

Effective Date

05/14/2021

Expiration Date

05/31/2023

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2021