DOMINIC CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153445

License Status

NOT RENEWED

Business

First Name

DOMINIC

Last Name

CLARK

Business Name

DOMINIC CLARK

Original Issue Date

03/02/2004

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

05/14/2007