JACOB RYAN WALTER - Pharmacist License in Illinois | # 049156118

JACOB RYAN WALTER

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156118

License Status

NOT RENEWED

Business

N

First Name

JACOB

Middle

RYAN

Last Name

WALTER

Business Name

JACOB RYAN WALTER

Original Issue Date

07/20/2004

Effective Date

08/28/2008

Expiration Date

03/31/2009

State

IL

Ever Disciplined

N

LastModifiedDate

05/06/2009