NATHANIEL EDMUND JENNETTEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155252

License Status

NOT RENEWED

Business

First Name

NATHANIEL

Middle

EDMUND

Last Name

JENNETTEN

Business Name

NATHANIEL EDMUND JENNETTEN

Original Issue Date

06/16/2004

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

05/14/2007