KELLI A GREEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049099577

License Status

NOT RENEWED

Business

First Name

KELLI A

Last Name

GREEN

Business Name

KELLI A GREEN

Original Issue Date

03/04/1992

Effective Date

03/04/1992

Expiration Date

03/31/1997

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005