BLAZE EDWARD GONZALEZ - Pharmacist License in Illinois | # 049191996

BLAZE EDWARD GONZALEZ

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049191996

License Status

NOT RENEWED

Business

N

First Name

BLAZE

Middle

EDWARD

Last Name

GONZALEZ

Business Name

BLAZE EDWARD GONZALEZ

Original Issue Date

05/28/2009

Effective Date

05/28/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010