KENNEDY MARIE PROVO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049284259

License Status

NOT RENEWED

Business

First Name

KENNEDY

Middle

MARIE

Last Name

PROVO

Business Name

KENNEDY MARIE PROVO

Original Issue Date

07/23/2021

Effective Date

06/01/2022

Expiration Date

03/31/2023

City

SPRINGFIELD

State

Zip

62703

Ever Disciplined

LastModifiedDate

09/07/2023