KELLY M HODGE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159321

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

HODGE

Business Name

KELLY M HODGE

Original Issue Date

02/22/2005

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007