ETHAN JACOB LEE PEECK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049247827

License Status

NOT RENEWED

Business

First Name

ETHAN

Middle

JACOB LEE

Last Name

PEECK

Business Name

ETHAN JACOB LEE PEECK

Original Issue Date

01/17/2017

Effective Date

02/01/2018

Expiration Date

03/31/2019

City

CENTRALIA

State

Zip

62801

County

CLINTON

Ever Disciplined

LastModifiedDate

07/15/2019