TINA MARIE CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049151962

License Status

NOT RENEWED

Business

First Name

TINA

Middle

MARIE

Last Name

CLARK

Business Name

TINA MARIE CLARK

Original Issue Date

10/30/2003

Effective Date

02/15/2011

Expiration Date

03/31/2012

City

WESTVILLE

State

Zip

61883

County

VERMILION

Ever Disciplined

LastModifiedDate

05/07/2012