KEVIN SHANE CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114650

License Status

NOT RENEWED

Business

First Name

KEVIN SHANE

Last Name

CLARK

Business Name

KEVIN SHANE CLARK

Original Issue Date

07/13/1996

Effective Date

07/13/1996

Expiration Date

03/31/1997

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

11/29/2016