BLACQUEE ISOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049287642

License Status

NOT RENEWED

Business

First Name

BLACQUEE

Last Name

ISOM

Business Name

BLACQUEE ISOM

Original Issue Date

11/05/2021

Effective Date

03/16/2023

Expiration Date

03/31/2024

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

01/03/2025