KRYSTINA E BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049228917

License Status

NOT RENEWED

Business

First Name

KRYSTINA

Middle

Last Name

BLAKE

Business Name

KRYSTINA E BLAKE

Original Issue Date

10/30/2014

Effective Date

10/30/2014

Expiration Date

03/31/2015

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/11/2015