MARTY KEITH ELLIOTT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138860

License Status

NOT RENEWED

Business

First Name

MARTY

Middle

KEITH

Last Name

ELLIOTT

Business Name

MARTY KEITH ELLIOTT

Original Issue Date

10/26/2001

Effective Date

10/26/2001

Expiration Date

03/31/2002

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

12/06/2005