JACOB DANIEL FOUTS - Pharmacist License in Illinois | # 049156049

JACOB DANIEL FOUTS

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156049

License Status

NOT RENEWED

Business

N

First Name

JACOB

Middle

DANIEL

Last Name

FOUTS

Business Name

JACOB DANIEL FOUTS

Original Issue Date

07/09/2004

Effective Date

07/09/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006