TISA K KELLEY Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051040771

License Status

INACTIVE

Business

First Name

TISA

Middle

Last Name

KELLEY

Business Name

TISA K KELLEY

Original Issue Date

04/16/1996

Effective Date

02/17/2012

Expiration Date

03/31/2014

City

INDIANAPOLIS

State

Zip

46256

County

INDIANA

Ever Disciplined

LastModifiedDate

01/09/2014