ROBERTA JEAN M CLARK Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049067520

License Status

CANCELLED

Business

First Name

ROBERTA JEAN M

Last Name

CLARK

Business Name

ROBERTA JEAN M CLARK

Original Issue Date

06/17/1977

Effective Date

06/17/1977

Expiration Date

03/31/1984

City

DIX

State

Zip

62830

County

JEFFERSON

Ever Disciplined

LastModifiedDate

10/17/2005