JACOB RYAN WALTER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156118

License Status

NOT RENEWED

Business

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

City

MENDOTA

State

Zip

61342

County

LA SALLE

Ever Disciplined

LastModifiedDate

05/06/2009