KAILEY NICOLE GOFORTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049246098

License Status

NOT RENEWED

Business

First Name

KAILEY

Middle

NICOLE

Last Name

GOFORTH

Business Name

KAILEY NICOLE GOFORTH

Original Issue Date

11/07/2016

Effective Date

01/13/2017

Expiration Date

03/31/2018

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

06/19/2018