KIM T MICHELETTI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154712

License Status

NOT RENEWED

Business

First Name

KIM

Middle

Last Name

MICHELETTI

Business Name

KIM T MICHELETTI

Original Issue Date

06/02/2004

Effective Date

06/02/2004

Expiration Date

03/31/2005

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/20/2005