TED A STARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049051395

License Status

NOT RENEWED

Business

First Name

TED A

Last Name

STARK

Business Name

TED A STARK

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005