POLLY SUZANNE KETCHUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049178266

License Status

NOT RENEWED

Business

First Name

POLLY

Middle

SUZANNE

Last Name

KETCHUM

Business Name

POLLY SUZANNE KETCHUM

Original Issue Date

08/07/2007

Effective Date

03/15/2012

Expiration Date

03/31/2013

City

QUINCY

State

Zip

62305

County

ADAMS

Ever Disciplined

LastModifiedDate

05/06/2013