BLAKE A FIELDS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049212024

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

FIELDS

Prefix

Business Name

BLAKE A FIELDS

Original Issue Date

07/07/2012

Effective Date

02/25/2013

Expiration Date

03/31/2014

City

EVANSTON

State

Zip

60202

Ever Disciplined

LastModifiedDate

05/06/2014