KELLEY D BRACKEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164276

License Status

NOT RENEWED

Business

First Name

KELLEY

Middle

Last Name

BRACKEN

Business Name

KELLEY D BRACKEN

Original Issue Date

09/29/2005

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

ILLIOPOLIS

State

Zip

62539

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/14/2007