JACQUIE MOUTON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049112377

License Status

NOT RENEWED

Business

First Name

JACQUIE

Last Name

MOUTON

Business Name

JACQUIE MOUTON

Original Issue Date

11/08/1995

Effective Date

11/08/1995

Expiration Date

03/31/1997

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/17/2005