WANDA JACKSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049071923

License Status

NOT RENEWED

Business

First Name

WANDA

Last Name

JACKSON

Business Name

WANDA JACKSON

Original Issue Date

09/21/1979

Effective Date

02/27/2018

Expiration Date

03/31/2019

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

07/15/2019