AUTUMN L CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157707

License Status

NOT RENEWED

Business

First Name

AUTUMN

Middle

Last Name

CLARK

Business Name

AUTUMN L CLARK

Original Issue Date

11/03/2004

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

MILL SHOALS

State

Zip

62862

County

WHITE

Ever Disciplined

LastModifiedDate

05/14/2007