KELLY M FREDERIKSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162941

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

FREDERIKSEN

Business Name

KELLY M FREDERIKSEN

Original Issue Date

08/11/2005

Effective Date

08/11/2005

Expiration Date

03/31/2006

City

AURORA

State

Zip

60504

Ever Disciplined

LastModifiedDate

05/11/2006