TISA K KELLEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049096979

License Status

NOT RENEWED

Business

First Name

TISA

Middle

Last Name

KELLEY

Business Name

TISA K KELLEY

Original Issue Date

05/25/1991

Effective Date

05/25/1991

Expiration Date

03/31/1993

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005