ANTOINE A BLAKE - Pharmacist License in Illinois | # 049163130

ANTOINE A BLAKE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049163130

License Status

NOT RENEWED

Business

N

First Name

ANTOINE

Middle

A

Last Name

BLAKE

Business Name

ANTOINE A BLAKE

Original Issue Date

08/23/2005

Effective Date

08/23/2005

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006