BLAISE FOSANOH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049266805

License Status

NOT RENEWED

Business

First Name

BLAISE

Last Name

FOSANOH

Business Name

BLAISE FOSANOH

Original Issue Date

07/22/2019

Effective Date

07/22/2019

Expiration Date

09/30/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

01/08/2021