MIKAELYN GRAYCE BLASSAGE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049235469

License Status

NOT RENEWED

Business

First Name

MIKAELYN

Middle

GRAYCE

Last Name

BLASSAGE

Business Name

MIKAELYN GRAYCE BLASSAGE

Original Issue Date

08/13/2015

Effective Date

02/25/2016

Expiration Date

03/31/2017

City

CHERRY VALLEY

State

Zip

61016

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/10/2017