GARY D BLOOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049059299

License Status

NOT RENEWED

Business

First Name

GARY D

Last Name

BLOOM

Business Name

GARY D BLOOM

Original Issue Date

03/30/1973

Effective Date

03/30/1973

Expiration Date

03/31/1986

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005