LORI M BLAUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149451

License Status

NOT RENEWED

Business

First Name

LORI

Middle

Last Name

BLAUM

Business Name

LORI M BLAUM

Original Issue Date

07/09/2003

Effective Date

07/09/2003

Expiration Date

03/31/2004

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/20/2005