BRIAN M BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156132

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

BLACK

Business Name

BRIAN M BLACK

Original Issue Date

07/20/2004

Effective Date

09/28/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008