BRENTON J CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133230

License Status

NOT RENEWED

Business

First Name

BRENTON

Middle

Last Name

CLARK

Business Name

BRENTON J CLARK

Original Issue Date

10/17/2000

Effective Date

10/17/2000

Expiration Date

03/31/2001

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/21/2005