SUSAN M JACOBSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049202951

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

JACOBSEN

Prefix

Business Name

SUSAN M JACOBSEN

Original Issue Date

03/01/2011

Effective Date

09/05/2012

Expiration Date

03/31/2013

City

UTICA

State

Zip

61373

County

LA SALLE

Ever Disciplined

LastModifiedDate

05/06/2013