BENJAMIN D BLITZBLAU Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049127905

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

Last Name

BLITZBLAU

Business Name

BENJAMIN D BLITZBLAU

Original Issue Date

10/15/1999

Effective Date

03/10/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007