JACOB L GOODMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049125162

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

Last Name

GOODMAN

Business Name

JACOB L GOODMAN

Original Issue Date

03/26/1999

Effective Date

03/26/1999

Expiration Date

03/31/2000

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/21/2005