JACK JAMES TIDABACK Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051035221

License Status

ACTIVE

Business

First Name

JACK JAMES

Last Name

TIDABACK

Business Name

JACK JAMES TIDABACK

Original Issue Date

05/17/1984

Effective Date

02/05/2026

Expiration Date

03/31/2028

City

GRAND RIDGE

State

Zip

61325

County

LA SALLE

Ever Disciplined

LastModifiedDate

02/05/2026