SAVANNAH BROOKE BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049221064

License Status

NOT RENEWED

Business

First Name

SAVANNAH

Middle

BROOKE

Last Name

BLAKE

Business Name

SAVANNAH BROOKE BLAKE

Original Issue Date

09/25/2013

Effective Date

01/28/2015

Expiration Date

03/31/2016

City

HIGHLAND

State

Zip

62249

County

MADISON

Ever Disciplined

LastModifiedDate

05/20/2016