BLAKE MICHAEL LACEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049268872

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

MICHAEL

Last Name

LACEY

Business Name

BLAKE MICHAEL LACEY

Original Issue Date

10/28/2019

Effective Date

01/30/2020

Expiration Date

03/31/2021

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/20/2021