KIMBERLY ANN FIETSAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049065915

License Status

NOT RENEWED

Business

First Name

KIMBERLY ANN

Last Name

FIETSAM

Business Name

KIMBERLY ANN FIETSAM

Original Issue Date

08/13/1976

Effective Date

08/13/1976

Expiration Date

01/01/1997

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/17/2005