KATHLEEN M SPACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049100998

License Status

NOT RENEWED

Business

First Name

KATHLEEN M

Last Name

SPACK

Business Name

KATHLEEN M SPACK

Original Issue Date

08/13/1992

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007