BLAKE A WENTWORTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049243333

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

WENTWORTH

Prefix

Business Name

BLAKE A WENTWORTH

Original Issue Date

07/18/2016

Effective Date

02/13/2020

Expiration Date

03/31/2021

City

METROPOLIS

State

Zip

62960

County

MASSAC

Ever Disciplined

LastModifiedDate

07/20/2021