ANDREA MICHELLE JACOBS-BLOCK - Pharmacist License in Illinois | # 049149259

ANDREA MICHELLE JACOBS-BLOCK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149259

License Status

NOT RENEWED

Business

N

First Name

ANDREA

Middle

MICHELLE

Last Name

JACOBS-BLOCK

Business Name

ANDREA MICHELLE JACOBS-BLOCK

Original Issue Date

06/25/2003

Effective Date

06/25/2003

Expiration Date

03/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005