JACQUELINE M CHAMPLAIN - Pharmacist License in Illinois | # 049158310

JACQUELINE M CHAMPLAIN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158310

License Status

NOT RENEWED

Business

N

First Name

JACQUELINE

Middle

M

Last Name

CHAMPLAIN

Business Name

JACQUELINE M CHAMPLAIN

Original Issue Date

12/13/2004

Effective Date

12/13/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006