THEOPHANY ANNE BLANCO C Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049236799

License Status

NOT RENEWED

Business

First Name

THEOPHANY

Middle

ANNE

Last Name

BLANCO

Suffix

Business Name

THEOPHANY ANNE BLANCO C

Original Issue Date

10/05/2015

Effective Date

10/05/2015

Expiration Date

03/31/2016

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Ever Disciplined

LastModifiedDate

05/20/2016