MARISSA ANNE BLANK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158344

License Status

NOT RENEWED

Business

First Name

MARISSA

Middle

ANNE

Last Name

BLANK

Business Name

MARISSA ANNE BLANK

Original Issue Date

12/15/2004

Effective Date

03/05/2022

Expiration Date

03/31/2023

City

MARISSA

State

Zip

62257

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/07/2023