POLLY ROXANNE KOLTHOFF Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140912

License Status

NOT RENEWED

Business

First Name

POLLY

Middle

ROXANNE

Last Name

KOLTHOFF

Business Name

POLLY ROXANNE KOLTHOFF

Original Issue Date

02/21/2002

Effective Date

03/01/2010

Expiration Date

03/31/2011

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/12/2011