JEREMY JUSTIN COSTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210962

License Status

NOT RENEWED

Business

First Name

JEREMY

Middle

JUSTIN

Last Name

COSTA

Business Name

JEREMY JUSTIN COSTA

Original Issue Date

05/11/2012

Effective Date

05/11/2012

Expiration Date

03/31/2013

City

WEST LAFAYETTE

State

Zip

47906

County

INDIANA

Ever Disciplined

LastModifiedDate

05/06/2013