IMANI ALIZE MONET LA'TRICE JACKSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049267609

License Status

NOT RENEWED

Business

First Name

IMANI

Middle

ALIZE MONET LA'TRICE

Last Name

JACKSON

Business Name

IMANI ALIZE MONET LA'TRICE JACKSON

Original Issue Date

08/30/2019

Effective Date

08/30/2019

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

01/08/2021