DOUGLAS LEE CLARK - Pharmacist License in Wisconsin | # 051029966

DOUGLAS LEE CLARK

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029966

License Status

INACTIVE

Business

N

First Name

DOUGLAS LEE

Last Name

CLARK

Business Name

DOUGLAS LEE CLARK

Original Issue Date

08/02/1974

Effective Date

08/02/1974

Expiration Date

03/31/1998

State

WI

Ever Disciplined

N

LastModifiedDate

10/17/2005