HOLLY A KLISIAK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049203130

License Status

NOT RENEWED

Business

First Name

HOLLY

Middle

Last Name

KLISIAK

Prefix

Business Name

HOLLY A KLISIAK

Original Issue Date

03/10/2011

Effective Date

03/10/2011

Expiration Date

03/31/2012

City

LOWELL

State

Zip

46356

County

INDIANA

Ever Disciplined

LastModifiedDate

05/07/2012