KELLY M COOK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049169403

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

COOK

Business Name

KELLY M COOK

Original Issue Date

06/19/2006

Effective Date

06/19/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007