DIANE R BLOK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049093870

License Status

NOT RENEWED

Business

First Name

DIANE R

Last Name

BLOK

Business Name

DIANE R BLOK

Original Issue Date

07/20/1990

Effective Date

07/20/1990

Expiration Date

03/31/2005

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Ever Disciplined

LastModifiedDate

10/20/2005