BLAKE NATHANIEL LEWIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049262488

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

NATHANIEL

Last Name

LEWIS

Business Name

BLAKE NATHANIEL LEWIS

Original Issue Date

12/31/2018

Effective Date

10/30/2023

Expiration Date

03/31/2024

City

DAVENPORT

State

Zip

52804

Ever Disciplined

LastModifiedDate

01/03/2025