COLLIN EDWARD BLACK - Pharmacist License in Illinois | # 049123397

COLLIN EDWARD BLACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049123397

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005