STEPHAN BLAKE - Pharmacist License in Illinois | # 049229621

STEPHAN BLAKE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049229621

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2015