JACK R PETERSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155032

License Status

NOT RENEWED

Business

First Name

JACK

Middle

Last Name

PETERSON

Business Name

JACK R PETERSON

Original Issue Date

06/11/2004

Effective Date

01/11/2013

Expiration Date

03/31/2014

City

GERMANTOWN HILLS

State

Zip

61548

County

WOODFORD

Ever Disciplined

LastModifiedDate

05/06/2014