ERIC L BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115039

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

Last Name

BLACK

Business Name

ERIC L BLACK

Original Issue Date

08/22/1996

Effective Date

08/22/1996

Expiration Date

03/31/2004

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

10/20/2005