BRICE WILLIAM BLATZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149011

License Status

NOT RENEWED

Business

First Name

BRICE

Middle

WILLIAM

Last Name

BLATZ

Business Name

BRICE WILLIAM BLATZ

Original Issue Date

06/19/2003

Effective Date

06/19/2003

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005