KEITH JACOB Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049068071

License Status

NOT RENEWED

Business

First Name

KEITH

Last Name

JACOB

Business Name

KEITH JACOB

Original Issue Date

09/09/1977

Effective Date

09/09/1977

Expiration Date

01/01/1997

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/17/2005