LESLIE D CLAYCOMB III Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049109359

License Status

NOT RENEWED

Business

First Name

LESLIE D

Last Name

CLAYCOMB III

Business Name

LESLIE D CLAYCOMB III

Original Issue Date

01/24/1995

Effective Date

01/31/2012

Expiration Date

03/31/2013

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/06/2013