SAMANTHA KELLIE SIPPEL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049275156

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

KELLIE

Last Name

SIPPEL

Business Name

SAMANTHA KELLIE SIPPEL

Original Issue Date

08/18/2020

Effective Date

03/05/2021

Expiration Date

05/31/2022

City

PEORIA

State

Zip

61606

Ever Disciplined

LastModifiedDate

07/27/2022