WILLIAM DERRICK BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049259934

License Status

NOT RENEWED

Business

First Name

WILLIAM

Middle

DERRICK

Last Name

BLAKE

Business Name

WILLIAM DERRICK BLAKE

Original Issue Date

09/19/2018

Effective Date

05/14/2022

Expiration Date

03/31/2023

City

ANTIOCH

State

Zip

60002

County

LAKE

Ever Disciplined

LastModifiedDate

09/07/2023