JAMIE J MATHIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154682

License Status

NOT RENEWED

Business

First Name

JAMIE

Middle

Last Name

MATHIS

Business Name

JAMIE J MATHIS

Original Issue Date

05/28/2004

Effective Date

05/28/2004

Expiration Date

03/31/2005

City

PORT BYRON

State

Zip

61275

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/20/2005