JASON TODD ALTENBAUMER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145891

License Status

NOT RENEWED

Business

First Name

JASON

Middle

TODD

Last Name

ALTENBAUMER

Business Name

JASON TODD ALTENBAUMER

Original Issue Date

11/19/2002

Effective Date

11/19/2002

Expiration Date

03/31/2004

City

SANDOVAL

State

Zip

62882

County

MARION

Ever Disciplined

LastModifiedDate

10/20/2005