MATTIE R JACKSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049080001

License Status

NOT RENEWED

Business

First Name

MATTIE R

Last Name

JACKSON

Business Name

MATTIE R JACKSON

Original Issue Date

07/31/1984

Effective Date

07/31/1984

Expiration Date

03/31/1986

City

EAST ST LOUIS

State

Zip

62203

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/17/2005