PHILLIP M BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049098175

License Status

NOT RENEWED

Business

First Name

PHILLIP M

Last Name

BLACK

Business Name

PHILLIP M BLACK

Original Issue Date

09/27/1991

Effective Date

09/27/1991

Expiration Date

03/31/1993

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/17/2005