JASON THOMAS MELLEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049239801

License Status

NOT RENEWED

Business

First Name

JASON

Middle

THOMAS

Last Name

MELLEN

Business Name

JASON THOMAS MELLEN

Original Issue Date

02/29/2016

Effective Date

04/03/2017

Expiration Date

03/31/2018

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

06/19/2018