KELLY ANNE BLACK - Pharmacist License in Illinois | # 049122271

KELLY ANNE BLACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122271

License Status

NOT RENEWED

Business

N

First Name

KELLY

Middle

ANNE

Last Name

BLACK

Business Name

KELLY ANNE BLACK

Original Issue Date

08/05/1998

Effective Date

08/05/1998

Expiration Date

03/31/1999

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005