JULIA ELLEN MAUD DEN BLAAUWEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133883

License Status

NOT RENEWED

Business

First Name

JULIA

Middle

ELLEN MAUD

Last Name

DEN BLAAUWEN

Business Name

JULIA ELLEN MAUD DEN BLAAUWEN

Original Issue Date

12/05/2000

Effective Date

12/05/2000

Expiration Date

03/31/2002

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

12/06/2005