SHANE JASON LAKE Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049320176

License Status

ACTIVE

Business

First Name

SHANE

Middle

JASON

Last Name

LAKE

Business Name

SHANE JASON LAKE

Original Issue Date

05/13/2025

Effective Date

05/13/2025

Expiration Date

03/31/2026

City

CARPENTERSVILLE

State

Zip

60110

County

ADAMS

Ever Disciplined

LastModifiedDate

01/30/2026