AUDREY M BLEVENS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164496

License Status

NOT RENEWED

Business

First Name

AUDREY

Middle

Last Name

BLEVENS

Business Name

AUDREY M BLEVENS

Original Issue Date

08/15/2005

Effective Date

10/19/2005

Expiration Date

03/31/2006

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

05/11/2006