KELLY BROADNAX Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049132162

License Status

NOT RENEWED

Business

First Name

KELLY

Last Name

BROADNAX

Business Name

KELLY BROADNAX

Original Issue Date

08/15/2000

Effective Date

08/15/2000

Expiration Date

03/31/2002

City

HARVEY

State

Zip

60426

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2005