The holder whose full name is SHAFFER, JEREMY DANIEL,come from Lanesville IN,hold the Pharmacy Intern license(NO.45012111A) which status is Superceded.
| Name | SHAFFER, JEREMY DANIEL |
|---|---|
| License Number | 45012111A |
| License Type | Pharmacy Intern |
| License Status | Superceded |
| City | Lanesville |
| State | IN |