CHAMPAINE DYSHAI BLACKWELL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049299234

License Status

NOT RENEWED

Business

First Name

CHAMPAINE

Middle

DYSHAI

Last Name

BLACKWELL

Business Name

CHAMPAINE DYSHAI BLACKWELL

Original Issue Date

01/18/2023

Effective Date

01/18/2023

Expiration Date

03/31/2024

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/03/2025