JEREMY TALLACKSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049235208

License Status

NOT RENEWED

Business

First Name

JEREMY

Last Name

TALLACKSEN

Prefix

Business Name

JEREMY TALLACKSEN

Original Issue Date

08/04/2015

Effective Date

04/03/2017

Expiration Date

03/31/2018

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/19/2018