MARK CHARLES BLOOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061393

License Status

NOT RENEWED

Business

First Name

MARK CHARLES

Last Name

BLOOM

Business Name

MARK CHARLES BLOOM

Original Issue Date

04/26/1974

Effective Date

04/26/1974

Expiration Date

01/01/1997

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/17/2005