JACLYN J HAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157450

License Status

NOT RENEWED

Business

First Name

JACLYN

Middle

Last Name

HAKE

Business Name

JACLYN J HAKE

Original Issue Date

10/13/2004

Effective Date

10/13/2004

Expiration Date

03/31/2005

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/20/2005