JACOB WILLIAM KELLEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049267070

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

WILLIAM

Last Name

KELLEY

Business Name

JACOB WILLIAM KELLEY

Original Issue Date

08/02/2019

Effective Date

08/02/2019

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

01/08/2021