BLAKE MALIK MACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049261781

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

MALIK

Last Name

MACK

Business Name

BLAKE MALIK MACK

Original Issue Date

12/03/2018

Effective Date

01/14/2020

Expiration Date

03/31/2021

City

SUN RIVER TERRACE

State

Zip

60964

County

KANKAKEE

Ever Disciplined

LastModifiedDate

07/20/2021