PATRICK D BLACKER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049202051

License Status

NOT RENEWED

Business

First Name

PATRICK

Middle

Last Name

BLACKER

Prefix

Business Name

PATRICK D BLACKER

Original Issue Date

12/22/2010

Effective Date

03/28/2011

Expiration Date

03/31/2012

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/07/2012