DERYCK R BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051038613

License Status

NOT RENEWED

Business

First Name

DERYCK R

Last Name

BLAKE

Business Name

DERYCK R BLAKE

Original Issue Date

10/16/1991

Effective Date

10/16/1991

Expiration Date

03/31/1992

City

MIAMI

State

Zip

33055

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/17/2005