KEELA JAN SHULL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155611

License Status

NOT RENEWED

Business

First Name

KEELA

Middle

JAN

Last Name

SHULL

Business Name

KEELA JAN SHULL

Original Issue Date

06/23/2004

Effective Date

06/23/2004

Expiration Date

03/31/2005

City

ARCOLA

State

Zip

61910

County

DOUGLAS

Ever Disciplined

LastModifiedDate

10/20/2005