LATAISHA M JACK - Pharmacist License in Illinois | # 049133906

LATAISHA M JACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133906

License Status

NOT RENEWED

Business

N

First Name

LATAISHA

Middle

M

Last Name

JACK

Business Name

LATAISHA M JACK

Original Issue Date

12/05/2000

Effective Date

01/09/2007

Expiration Date

03/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

05/02/2008