BLAKE L CORNWELL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049212371

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

CORNWELL

Prefix

Business Name

BLAKE L CORNWELL

Original Issue Date

07/23/2012

Effective Date

03/11/2019

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

01/08/2021