KELLY SHAUNE BURGESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157155

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

SHAUNE

Last Name

BURGESS

Business Name

KELLY SHAUNE BURGESS

Original Issue Date

09/09/2004

Effective Date

09/09/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60626

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006