MICHAEL P BLACKBURN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049116377

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

BLACKBURN

Business Name

MICHAEL P BLACKBURN

Original Issue Date

01/30/1997

Effective Date

01/30/1997

Expiration Date

03/31/2004

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/20/2005