KETRINA DE CHAMP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049215194

License Status

NOT RENEWED

Business

First Name

KETRINA

Middle

Last Name

CHAMP

Prefix

Business Name

KETRINA DE CHAMP

Original Issue Date

12/28/2012

Effective Date

12/28/2012

Expiration Date

03/31/2013

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/06/2013