DIANE K BLOSSER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049224042

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

BLOSSER

Business Name

DIANE K BLOSSER

Original Issue Date

03/24/2014

Effective Date

03/24/2014

Expiration Date

03/31/2015

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2015