GRANT BLAZINA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049191131

License Status

NOT RENEWED

Business

First Name

GRANT

Last Name

BLAZINA

Business Name

GRANT BLAZINA

Original Issue Date

04/17/2009

Effective Date

01/19/2010

Expiration Date

03/31/2011

City

NAPERVILLE

State

Zip

60564

Ever Disciplined

LastModifiedDate

05/12/2011