KATHRYN ALICIA POLK-KHAZNEH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160158

License Status

NOT RENEWED

Business

First Name

KATHRYN

Middle

ALICIA

Last Name

POLK-KHAZNEH

Business Name

KATHRYN ALICIA POLK-KHAZNEH

Original Issue Date

04/13/2005

Effective Date

10/26/2020

Expiration Date

03/31/2021

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/20/2021