WILLIAM MARTIN JACOBSEN Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051034534

License Status

INACTIVE

Business

First Name

WILLIAM MARTIN

Last Name

JACOBSEN

Business Name

WILLIAM MARTIN JACOBSEN

Original Issue Date

08/10/1982

Effective Date

08/10/1982

Expiration Date

03/31/1986

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005