STACEY A BLOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114682

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

BLOCK

Business Name

STACEY A BLOCK

Original Issue Date

07/23/1996

Effective Date

07/23/1996

Expiration Date

03/31/2002

City

DES PLAINES

State

Zip

60018

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2005