E ROBERTA JACKSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049065187

License Status

NOT RENEWED

Business

First Name

E ROBERTA

Last Name

JACKSON

Business Name

E ROBERTA JACKSON

Original Issue Date

04/16/1976

Effective Date

04/16/1976

Expiration Date

01/01/1997

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

10/17/2005