CLAYTON ELLIS BALLARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138458

License Status

NOT RENEWED

Business

First Name

CLAYTON

Middle

ELLIS

Last Name

BALLARD

Business Name

CLAYTON ELLIS BALLARD

Original Issue Date

09/25/2001

Effective Date

09/25/2001

Expiration Date

03/31/2003

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005