VALERIE MICHELLE BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149345

License Status

NOT RENEWED

Business

First Name

VALERIE

Middle

MICHELLE

Last Name

BLAKE

Business Name

VALERIE MICHELLE BLAKE

Original Issue Date

06/30/2003

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

05/02/2008