RUSSELL ALAN CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049113877

License Status

NOT RENEWED

Business

First Name

RUSSELL ALAN

Last Name

CLARK

Business Name

RUSSELL ALAN CLARK

Original Issue Date

04/01/1996

Effective Date

04/01/1996

Expiration Date

03/31/1997

City

ELMWOOD

State

Zip

61529

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005