DWAYNE E BLACKAMORE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049171153

License Status

NOT RENEWED

Business

First Name

DWAYNE

Middle

Last Name

BLACKAMORE

Business Name

DWAYNE E BLACKAMORE

Original Issue Date

09/07/2006

Effective Date

09/07/2006

Expiration Date

03/31/2007

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

05/14/2007