JACOB LEE LICKLIDER Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049199670

License Status

INACTIVE

Business

First Name

JACOB

Middle

LEE

Last Name

LICKLIDER

Business Name

JACOB LEE LICKLIDER

Original Issue Date

07/29/2010

Effective Date

04/16/2020

Expiration Date

03/31/2021

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

01/10/2021