NATHANIEL MITCHELL JACKSTADT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049262978

License Status

NOT RENEWED

Business

First Name

NATHANIEL

Middle

MITCHELL

Last Name

JACKSTADT

Business Name

NATHANIEL MITCHELL JACKSTADT

Original Issue Date

01/31/2019

Effective Date

04/28/2021

Expiration Date

05/31/2022

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

07/27/2022