DAVID LEE MATLOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049134132

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

LEE

Last Name

MATLOCK

Business Name

DAVID LEE MATLOCK

Original Issue Date

12/19/2000

Effective Date

12/19/2000

Expiration Date

03/31/2002

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

12/06/2005