SHELLY J BOLEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049196044

License Status

NOT RENEWED

Business

First Name

SHELLY

Middle

Last Name

BOLEN

Business Name

SHELLY J BOLEN

Original Issue Date

01/04/2010

Effective Date

01/04/2010

Expiration Date

03/31/2011

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

05/12/2011