KELLY A BROCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051289743

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

BROCK

Business Name

KELLY A BROCK

Original Issue Date

11/04/2003

Effective Date

03/31/2004

Expiration Date

03/31/2006

City

IRVINE

State

Zip

92602

County

COLORADO

Ever Disciplined

LastModifiedDate

05/11/2006