BLAKE MALIK MACK - Pharmacist License in Illinois | # 049261781

BLAKE MALIK MACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049261781

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

07/20/2021