BLAKE FAWNS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049184875

License Status

NOT RENEWED

Business

First Name

BLAKE

Last Name

FAWNS

Business Name

BLAKE FAWNS

Original Issue Date

06/12/2008

Effective Date

02/13/2018

Expiration Date

03/31/2019

City

SHERMAN

State

Zip

62684

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/15/2019