THOMAS T JACOB Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145320

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

JACOB

Business Name

THOMAS T JACOB

Original Issue Date

10/16/2002

Effective Date

10/16/2002

Expiration Date

03/31/2003

City

STURTEVANT

State

Zip

53177

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/20/2005