BLAKE N FULTON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049234234

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

FULTON

Business Name

BLAKE N FULTON

Original Issue Date

07/03/2015

Effective Date

07/03/2015

Expiration Date

03/31/2016

City

CAHOKIA

State

Zip

62206

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/20/2016