BLAKE J LUTZOW Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049220021

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

LUTZOW

Business Name

BLAKE J LUTZOW

Original Issue Date

08/15/2013

Effective Date

02/26/2020

Expiration Date

03/31/2021

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/20/2021