DOMINISHA BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049247125

License Status

NOT RENEWED

Business

First Name

DOMINISHA

Last Name

BLAKE

Business Name

DOMINISHA BLAKE

Original Issue Date

12/15/2016

Effective Date

04/03/2017

Expiration Date

03/31/2018

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

06/19/2018