STEPHAN BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049229621

License Status

NOT RENEWED

Business

First Name

STEPHAN

Last Name

BLAKE

Business Name

STEPHAN BLAKE

Original Issue Date

11/30/2014

Effective Date

11/30/2014

Expiration Date

03/31/2015

City

LAKE IN THE HILLS

State

Zip

60156

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/11/2015