PHYLLIS LYNN JACOBS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049187058

License Status

NOT RENEWED

Business

First Name

PHYLLIS

Middle

LYNN

Last Name

JACOBS

Business Name

PHYLLIS LYNN JACOBS

Original Issue Date

09/17/2008

Effective Date

01/26/2009

Expiration Date

03/31/2010

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/04/2010