JEREK DALTON VIRGIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049246762

License Status

NOT RENEWED

Business

First Name

JEREK

Middle

DALTON

Last Name

VIRGIN

Business Name

JEREK DALTON VIRGIN

Original Issue Date

12/01/2016

Effective Date

03/19/2018

Expiration Date

03/31/2019

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/15/2019