KAYLA SUE BLOOME Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161383

License Status

NOT RENEWED

Business

First Name

KAYLA

Middle

SUE

Last Name

BLOOME

Business Name

KAYLA SUE BLOOME

Original Issue Date

05/31/2005

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

05/02/2008