LATAISHA M JACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133906

License Status

NOT RENEWED

Business

First Name

LATAISHA

Middle

Last Name

JACK

Business Name

LATAISHA M JACK

Original Issue Date

12/05/2000

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60632

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008