TERENCE W CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122492

License Status

NOT RENEWED

Business

First Name

TERENCE

Middle

Last Name

CLARK

Business Name

TERENCE W CLARK

Original Issue Date

08/19/1998

Effective Date

08/19/1998

Expiration Date

03/31/2001

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

10/21/2005