JESSE DYLAN BASHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049207926

License Status

NOT RENEWED

Business

First Name

JESSE

Middle

DYLAN

Last Name

BASHAM

Business Name

JESSE DYLAN BASHAM

Original Issue Date

11/21/2011

Effective Date

01/09/2013

Expiration Date

03/31/2014

City

WEST FRANKFORT

State

Zip

62896

County

FRANKLIN

Ever Disciplined

LastModifiedDate

05/06/2014