DIANE LARAE KISS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049267544

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

LARAE

Last Name

KISS

Business Name

DIANE LARAE KISS

Original Issue Date

08/27/2019

Effective Date

03/18/2021

Expiration Date

05/31/2022

City

DAVENPORT

State

Zip

52806

Ever Disciplined

LastModifiedDate

07/27/2022