LISA G CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138363

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

CLARK

Business Name

LISA G CLARK

Original Issue Date

09/19/2001

Effective Date

01/12/2010

Expiration Date

03/31/2011

City

MATTOON

State

Zip

61938

Ever Disciplined

LastModifiedDate

05/12/2011