SHANE JASON LAKE - Pharmacist License in Illinois | # 049320176

SHANE JASON LAKE

Business Entity

ACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049320176

License Status

ACTIVE

Business

N

First Name

SHANE

Middle

JASON

Last Name

LAKE

Business Name

SHANE JASON LAKE

Original Issue Date

05/13/2025

Effective Date

03/30/2026

Expiration Date

03/31/2027

State

IL

Ever Disciplined

N

LastModifiedDate

03/30/2026