JACOB WILLIAM LONG - Pharmacist License in Illinois | # 049155229

JACOB WILLIAM LONG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155229

License Status

NOT RENEWED

Business

N

First Name

JACOB

Middle

WILLIAM

Last Name

LONG

Business Name

JACOB WILLIAM LONG

Original Issue Date

06/16/2004

Effective Date

06/16/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006