BLAKE W PERKINS MD Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049173994

License Status

INACTIVE

Business

Title

First Name

BLAKE

Middle

Last Name

PERKINS

Business Name

BLAKE W PERKINS MD

Original Issue Date

01/29/2007

Effective Date

01/29/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

01/10/2008