PHYLLIS M BLANTON - Pharmacist License in Illinois | # 049155436

PHYLLIS M BLANTON

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155436

License Status

NOT RENEWED

Business

N

First Name

PHYLLIS

Middle

M

Last Name

BLANTON

Business Name

PHYLLIS M BLANTON

Original Issue Date

06/21/2004

Effective Date

09/17/2019

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/08/2021