TINA LOUISE KELLEMS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115296

License Status

NOT RENEWED

Business

First Name

TINA LOUISE

Last Name

KELLEMS

Business Name

TINA LOUISE KELLEMS

Original Issue Date

09/19/1996

Effective Date

09/19/1996

Expiration Date

03/31/2001

City

VILLA GROVE

State

Zip

61956

County

DOUGLAS

Ever Disciplined

LastModifiedDate

10/21/2005