BLAKE THOMAS MOSKAL MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210879

License Status

NOT RENEWED

Business

Title

First Name

BLAKE

Middle

THOMAS

Last Name

MOSKAL

Prefix

Business Name

BLAKE THOMAS MOSKAL MD

Original Issue Date

05/08/2012

Effective Date

03/15/2013

Expiration Date

03/31/2014

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

05/06/2014