DERRICK JOHN BLIZNICK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049173043

License Status

NOT RENEWED

Business

First Name

DERRICK

Middle

JOHN

Last Name

BLIZNICK

Business Name

DERRICK JOHN BLIZNICK

Original Issue Date

12/08/2006

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60630

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008