DAVID RATHBUN BLAZO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051293232

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

RATHBUN

Last Name

BLAZO

Business Name

DAVID RATHBUN BLAZO

Original Issue Date

05/05/2009

Effective Date

03/08/2022

Expiration Date

03/31/2024

City

SOUTH BEND

State

Zip

46628

County

INDIANA

Ever Disciplined

LastModifiedDate

02/05/2025