JACOB R FREDERICKS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049237925

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

Last Name

FREDERICKS

Business Name

JACOB R FREDERICKS

Original Issue Date

11/24/2015

Effective Date

02/24/2021

Expiration Date

05/31/2022

City

MOUNT OLIVE

State

Zip

62069

Ever Disciplined

LastModifiedDate

07/27/2022