STANLEY GENE JACOB Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049118072

License Status

NOT RENEWED

Business

First Name

STANLEY

Middle

GENE

Last Name

JACOB

Business Name

STANLEY GENE JACOB

Original Issue Date

07/09/1997

Effective Date

07/09/1997

Expiration Date

03/31/2000

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

10/21/2005