KIM RAE BLAGOUE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138459

License Status

NOT RENEWED

Business

First Name

KIM

Middle

RAE

Last Name

BLAGOUE

Business Name

KIM RAE BLAGOUE

Original Issue Date

09/26/2001

Effective Date

03/23/2009

Expiration Date

03/31/2010

City

BREESE

State

Zip

62230

County

CLINTON

Ever Disciplined

LastModifiedDate

05/04/2010