BLAYNE TAYLOR STREET Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049258794

License Status

NOT RENEWED

Business

First Name

BLAYNE

Middle

TAYLOR

Last Name

STREET

Business Name

BLAYNE TAYLOR STREET

Original Issue Date

07/11/2018

Effective Date

07/11/2018

Expiration Date

03/31/2019

City

WOODHULL

State

Zip

61490

County

HENRY

Ever Disciplined

LastModifiedDate

07/15/2019