KEITH A CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049071628

License Status

NOT RENEWED

Business

First Name

KEITH A

Last Name

CLARK

Business Name

KEITH A CLARK

Original Issue Date

07/27/1979

Effective Date

07/27/1979

Expiration Date

03/31/1996

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/17/2005