TIMOTHY D BLAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049205465

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

BLAKE

Business Name

TIMOTHY D BLAKE

Original Issue Date

07/20/2011

Effective Date

04/02/2012

Expiration Date

03/31/2013

City

JANESVILLE

State

Zip

53545

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/06/2013