JACOB R FREDERICKS Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051304276

License Status

ACTIVE

Business

First Name

JACOB

Middle

Last Name

FREDERICKS

Business Name

JACOB R FREDERICKS

Original Issue Date

09/15/2021

Effective Date

03/05/2026

Expiration Date

03/31/2028

City

MOUNT OLIVE

State

Zip

62069

Ever Disciplined

LastModifiedDate

03/05/2026