KENNETH P BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049067489

License Status

NOT RENEWED

Business

First Name

KENNETH P

Last Name

BLAKE

Business Name

KENNETH P BLAKE

Original Issue Date

06/17/1977

Effective Date

06/17/1977

Expiration Date

01/01/1997

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005