KELLY A KEITH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154811

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

KEITH

Business Name

KELLY A KEITH

Original Issue Date

06/08/2004

Effective Date

01/12/2010

Expiration Date

03/31/2011

City

DAVENPORT

State

Zip

52807

Ever Disciplined

LastModifiedDate

05/12/2011