KELLY L RAUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049141219

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

RAUM

Business Name

KELLY L RAUM

Original Issue Date

03/06/2002

Effective Date

03/06/2002

Expiration Date

03/31/2005

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005