TRAVIS WILLIAM JACKSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049187621

License Status

NOT RENEWED

Business

First Name

TRAVIS

Middle

WILLIAM

Last Name

JACKSON

Business Name

TRAVIS WILLIAM JACKSON

Original Issue Date

10/14/2008

Effective Date

02/13/2013

Expiration Date

03/31/2014

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

05/06/2014