JEROLD ROBERT SMITH Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057349

License Status

CANCELLED

Business

First Name

JEROLD ROBERT

Last Name

SMITH

Business Name

JEROLD ROBERT SMITH

Original Issue Date

02/02/1972

Effective Date

02/02/1972

Expiration Date

01/01/1997

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005