BRENT MICHEAL BLOEMER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049134221

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

MICHEAL

Last Name

BLOEMER

Business Name

BRENT MICHEAL BLOEMER

Original Issue Date

12/27/2000

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

TROY

State

Zip

62294

County

MADISON

Ever Disciplined

LastModifiedDate

05/14/2007