JENNIFER M BACKSTROM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153148

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

BACKSTROM

Business Name

JENNIFER M BACKSTROM

Original Issue Date

02/04/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2008