KELLY A LANGE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049129743

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

LANGE

Business Name

KELLY A LANGE

Original Issue Date

03/06/2000

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

ROCKTON

State

Zip

61072

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2008