NICOLE B BLAIR Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049152107

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

BLAIR

Business Name

NICOLE B BLAIR

Original Issue Date

11/06/2003

Effective Date

11/06/2003

Expiration Date

03/31/2004

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005