NATHAN R CLEMENTZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158739

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

Last Name

CLEMENTZ

Business Name

NATHAN R CLEMENTZ

Original Issue Date

01/04/2005

Effective Date

01/04/2005

Expiration Date

03/31/2006

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/11/2006