KYLE ALAN BLOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049260997

License Status

NOT RENEWED

Business

First Name

KYLE

Middle

ALAN

Last Name

BLOM

Business Name

KYLE ALAN BLOM

Original Issue Date

10/25/2018

Effective Date

02/26/2020

Expiration Date

03/31/2021

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

07/20/2021