JENNIFER SUZANNE MALLICOAT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051289125

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

SUZANNE

Last Name

MALLICOAT

Business Name

JENNIFER SUZANNE MALLICOAT

Original Issue Date

09/25/2002

Effective Date

09/25/2002

Expiration Date

03/31/2004

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

12/06/2005