BLAYNE PAUL FLECK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143754

License Status

NOT RENEWED

Business

First Name

BLAYNE

Middle

PAUL

Last Name

FLECK

Business Name

BLAYNE PAUL FLECK

Original Issue Date

07/18/2002

Effective Date

07/18/2002

Expiration Date

03/31/2003

City

CHATHAM

State

Zip

62629

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005