TARA MARIA JETTER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156766

License Status

NOT RENEWED

Business

First Name

TARA

Middle

MARIA

Last Name

JETTER

Business Name

TARA MARIA JETTER

Original Issue Date

08/19/2004

Effective Date

08/19/2004

Expiration Date

03/31/2006

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

05/11/2006