MARY BETH CLARK Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049059546

License Status

CANCELLED

Business

First Name

MARY BETH

Last Name

CLARK

Business Name

MARY BETH CLARK

Original Issue Date

05/24/1973

Effective Date

05/24/1973

Expiration Date

01/01/1997

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005