KELLY ANNE BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122271

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

ANNE

Last Name

BLACK

Business Name

KELLY ANNE BLACK

Original Issue Date

08/05/1998

Effective Date

08/05/1998

Expiration Date

03/31/1999

City

PALATINE

State

Zip

60067

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005