JAY V COSTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051027182

License Status

NOT RENEWED

Business

First Name

JAY V

Last Name

COSTA

Business Name

JAY V COSTA

Original Issue Date

01/01/1997

Expiration Date

03/31/1998

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/17/2005