SHAUNTAYE D CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049142109

License Status

NOT RENEWED

Business

First Name

SHAUNTAYE

Middle

Last Name

CLARK

Business Name

SHAUNTAYE D CLARK

Original Issue Date

05/02/2002

Effective Date

05/02/2002

Expiration Date

03/31/2003

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005