DIANA LYNN JACOBSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061460

License Status

NOT RENEWED

Business

First Name

DIANA LYNN

Last Name

JACOBSEN

Business Name

DIANA LYNN JACOBSEN

Original Issue Date

05/10/1974

Effective Date

02/06/2020

Expiration Date

03/31/2021

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

07/20/2021