KELLY T LANE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049079919

License Status

NOT RENEWED

Business

First Name

KELLY T

Last Name

LANE

Business Name

KELLY T LANE

Original Issue Date

07/05/1984

Effective Date

07/05/1984

Expiration Date

03/31/1986

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005