COLLIN EDWARD BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049123397

License Status

NOT RENEWED

Business

First Name

COLLIN

Middle

EDWARD

Last Name

BLACK

Business Name

COLLIN EDWARD BLACK

Original Issue Date

10/23/1998

Effective Date

10/23/1998

Expiration Date

03/31/2005

City

MCHENRY

State

Zip

60050

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/20/2005