JERRY W FREDERICK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049056486

License Status

NOT RENEWED

Business

First Name

JERRY W

Last Name

FREDERICK

Business Name

JERRY W FREDERICK

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

CROWN POINT

State

Zip

46307

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005