MALLORY ELIZABETH KAPITANOFF Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049211598

License Status

NOT RENEWED

Business

First Name

MALLORY

Middle

ELIZABETH

Last Name

KAPITANOFF

Prefix

Business Name

MALLORY ELIZABETH KAPITANOFF

Original Issue Date

06/10/2012

Effective Date

03/24/2015

Expiration Date

03/31/2016

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/20/2016