JORDAN WAYNE GALLUP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145598

License Status

NOT RENEWED

Business

First Name

JORDAN

Middle

WAYNE

Last Name

GALLUP

Business Name

JORDAN WAYNE GALLUP

Original Issue Date

10/30/2002

Effective Date

10/30/2002

Expiration Date

03/31/2006

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/11/2006