CLIFFORD J FREDERICK Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140677

License Status

INACTIVE

Business

First Name

CLIFFORD

Middle

Last Name

FREDERICK

Business Name

CLIFFORD J FREDERICK

Original Issue Date

02/15/2002

Effective Date

03/13/2009

Expiration Date

03/31/2010

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/12/2010