LORI LYNN KIETZMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049163497

License Status

NOT RENEWED

Business

First Name

LORI

Middle

LYNN

Last Name

KIETZMAN

Business Name

LORI LYNN KIETZMAN

Original Issue Date

09/02/2005

Effective Date

02/07/2012

Expiration Date

03/31/2013

City

PAXTON

State

Zip

60957

County

FORD

Ever Disciplined

LastModifiedDate

05/06/2013