JACQUELINE S GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159365

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Middle

Last Name

GUSTAFSON

Business Name

JACQUELINE S GUSTAFSON

Original Issue Date

02/23/2005

Effective Date

02/25/2011

Expiration Date

03/31/2012

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

05/07/2012