KEENIA FORTNER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049247182

License Status

NOT RENEWED

Business

First Name

KEENIA

Last Name

FORTNER

Business Name

KEENIA FORTNER

Original Issue Date

12/16/2016

Effective Date

12/16/2016

Expiration Date

03/31/2017

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2017