AMY SMITH BLAISE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049094457

License Status

NOT RENEWED

Business

First Name

AMY

Last Name

SMITH BLAISE

Business Name

AMY SMITH BLAISE

Original Issue Date

10/06/1990

Effective Date

10/06/1990

Expiration Date

03/31/1997

City

MOUNT VERNON

State

Zip

62864

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

10/17/2005