KELLY ANN GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049108528

License Status

NOT RENEWED

Business

First Name

KELLY ANN

Last Name

GUSTAFSON

Business Name

KELLY ANN GUSTAFSON

Original Issue Date

10/18/1994

Effective Date

10/18/1994

Expiration Date

03/31/1997

City

SANDWICH

State

Zip

60548

County

DEKALB

Ever Disciplined

LastModifiedDate

10/17/2005