MARK JOSEPH DEBLOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153351

License Status

NOT RENEWED

Business

First Name

MARK

Middle

JOSEPH

Last Name

DEBLOCK

Business Name

MARK JOSEPH DEBLOCK

Original Issue Date

02/27/2004

Effective Date

02/27/2004

Expiration Date

03/31/2005

City

BATAVIA

State

Zip

60510

County

KANE

Ever Disciplined

LastModifiedDate

10/20/2005