KELLY R MANCILLAS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049091914

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

MANCILLAS

Business Name

KELLY R MANCILLAS

Original Issue Date

12/22/1989

Effective Date

12/22/1989

Expiration Date

03/31/1990

City

WAUCONDA

State

Zip

60084

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005