Blake Joseph Larson
ExpiredCalifornia license 72234
License
- Licensed by
- California State Board of Pharmacy
- License number
- 72234
- Status
- Expired (Delinquent)
- First issued
- January 21, 2015
- Expired
- August 31, 2024
- License holder
- Blake Joseph Larson
- Entity type
- Individual
Classifications
- Registered Pharmacist Pharmacy
More from the license record
- License type code
- RPH
- School
- Pacific University Of Or
- Year graduated
- 2014
- Degree
- Pharm/d Or Dr. Of Pharmacy
Contact
922 Nw 11th Ave #511
Portland, OR 97209
Portland, OR 97209