JENNIFER MARIE BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049134350

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

MARIE

Last Name

BLACK

Business Name

JENNIFER MARIE BLACK

Original Issue Date

01/12/2001

Effective Date

01/12/2001

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/06/2005