KELLY SUE SHACKELFORD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049221890

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

SUE

Last Name

SHACKELFORD

Business Name

KELLY SUE SHACKELFORD

Original Issue Date

11/12/2013

Effective Date

02/13/2019

Expiration Date

09/30/2020

City

KENOSHA

State

Zip

53142

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/08/2021