JEFFREY S LAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049063740

License Status

NOT RENEWED

Business

First Name

JEFFREY S

Last Name

LAKE

Business Name

JEFFREY S LAKE

Original Issue Date

06/20/1975

Effective Date

06/20/1975

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005