JASON M PENGELLY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049129680

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

PENGELLY

Business Name

JASON M PENGELLY

Original Issue Date

03/02/2000

Effective Date

01/10/2008

Expiration Date

03/31/2009

City

HAINESVILLE

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

05/06/2009