JACK VAN BENTHEM Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051026963

License Status

INACTIVE

Business

First Name

JACK

Last Name

VAN BENTHEM

Business Name

JACK VAN BENTHEM

Original Issue Date

01/01/1997

Effective Date

02/02/2010

Expiration Date

03/31/2012

City

WAUPACA

State

Zip

54981

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/12/2012