BLAZE EDWARD GONZALEZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049191996

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010