Licensee Name:IREI JERALYN KIYOMI
License Type:PHARMACY TECHNICIAN
License Number:105251
License Status:CANCELLED Definition
Expiration Date:November 30, 2013
Issue Date:August 06, 2010
Address:230 W NORTH TEMPLE APT 624
City:SALT LAKE CITY
State:UT
Zip:84103
County:OUT OF STATE
Actions:No
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