JEREMY JUSTIN COSTA - Pharmacist License in Indiana | # 049210962

JEREMY JUSTIN COSTA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210962

License Status

NOT RENEWED

Business

N

First Name

JEREMY

Middle

JUSTIN

Last Name

COSTA

Business Name

JEREMY JUSTIN COSTA

Original Issue Date

05/11/2012

Effective Date

05/11/2012

Expiration Date

03/31/2013

State

IN

Ever Disciplined

N

LastModifiedDate

05/06/2013