MARK NICHOLAS BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049134290

License Status

NOT RENEWED

Business

First Name

MARK

Middle

NICHOLAS

Last Name

BLACK

Business Name

MARK NICHOLAS BLACK

Original Issue Date

01/05/2001

Effective Date

01/05/2001

Expiration Date

03/31/2006

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

05/11/2006