AUTUMN L CLARK - Pharmacist License in Illinois | # 049157707

AUTUMN L CLARK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157707

License Status

NOT RENEWED

Business

N

First Name

AUTUMN

Middle

L

Last Name

CLARK

Business Name

AUTUMN L CLARK

Original Issue Date

11/03/2004

Effective Date

01/19/2006

Expiration Date

03/31/2007

State

IL

Ever Disciplined

N

LastModifiedDate

05/14/2007