CHARLEY D KIETZMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049170978

License Status

NOT RENEWED

Business

First Name

CHARLEY

Middle

Last Name

KIETZMAN

Business Name

CHARLEY D KIETZMAN

Original Issue Date

08/30/2006

Effective Date

02/20/2014

Expiration Date

03/31/2015

City

PAXTON

State

Zip

60957

County

FORD

Ever Disciplined

LastModifiedDate

05/11/2015