TAWANNA D BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049178013

License Status

NOT RENEWED

Business

First Name

TAWANNA

Middle

Last Name

BLAKE

Business Name

TAWANNA D BLAKE

Original Issue Date

07/25/2007

Effective Date

03/02/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60660

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010