MARK CHARLES BLOOM - Pharmacist License in Illinois | # 049061393

MARK CHARLES BLOOM

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061393

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005