MADISON A BLACKBURN DPT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049234652

License Status

NOT RENEWED

Business

Title

DPT

First Name

MADISON

Middle

Last Name

BLACKBURN

Prefix

Business Name

MADISON A BLACKBURN DPT

Original Issue Date

07/21/2015

Effective Date

05/01/2022

Expiration Date

03/31/2023

City

MONTICELLO

State

Zip

61856

County

PIATT

Ever Disciplined

LastModifiedDate

09/07/2023