JENNIFER M STASIAK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049171566

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

STASIAK

Business Name

JENNIFER M STASIAK

Original Issue Date

09/21/2006

Effective Date

09/21/2006

Expiration Date

03/31/2007

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/14/2007