LISA ANN BLAYLOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049252089

License Status

NOT RENEWED

Business

First Name

LISA

Middle

ANN

Last Name

BLAYLOCK

Business Name

LISA ANN BLAYLOCK

Original Issue Date

08/01/2017

Effective Date

08/01/2017

Expiration Date

03/31/2018

City

CHICAGO

State

Zip

60634

County

COOK

Ever Disciplined

LastModifiedDate

06/19/2018