KELLY JEAN ALTIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049128851

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

JEAN

Last Name

ALTIS

Business Name

KELLY JEAN ALTIS

Original Issue Date

01/04/2000

Effective Date

01/04/2000

Expiration Date

03/31/2001

City

MONMOUTH

State

Zip

61462

County

WARREN

Ever Disciplined

LastModifiedDate

10/21/2005