JEFFERY A CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114350

License Status

NOT RENEWED

Business

First Name

JEFFERY A

Last Name

CLARK

Business Name

JEFFERY A CLARK

Original Issue Date

05/30/1996

Effective Date

05/30/1996

Expiration Date

03/31/1998

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005