KELLY M KLUBERTANZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157249

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

KLUBERTANZ

Business Name

KELLY M KLUBERTANZ

Original Issue Date

09/30/2004

Effective Date

09/30/2004

Expiration Date

03/31/2005

City

WINTER HAVEN

State

Zip

33884

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/20/2005