JACK J INGRAM III Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049110070

License Status

NOT RENEWED

Business

First Name

JACK J

Last Name

INGRAM III

Business Name

JACK J INGRAM III

Original Issue Date

04/04/1995

Effective Date

04/04/1995

Expiration Date

03/31/1997

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005