ANDREA MICHELLE JACOBS-BLOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149259

License Status

NOT RENEWED

Business

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

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Ever Disciplined

LastModifiedDate

10/20/2005