BRIAN P BLAYLOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049185970

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

BLAYLOCK

Business Name

BRIAN P BLAYLOCK

Original Issue Date

08/06/2008

Effective Date

03/16/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60707

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010