BLAKE J SORENSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049173279

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

SORENSEN

Business Name

BLAKE J SORENSEN

Original Issue Date

12/18/2006

Effective Date

03/01/2013

Expiration Date

03/31/2014

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/06/2014