JACOB DALLAS ALLEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049209597

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

DALLAS

Last Name

ALLEN

Business Name

JACOB DALLAS ALLEN

Original Issue Date

03/06/2012

Effective Date

03/19/2013

Expiration Date

03/31/2014

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/06/2014