NICHOLE T CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158947

License Status

NOT RENEWED

Business

First Name

NICHOLE

Middle

Last Name

CLARK

Business Name

NICHOLE T CLARK

Original Issue Date

01/26/2005

Effective Date

04/18/2011

Expiration Date

03/31/2012

City

BEACH PARK

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

05/07/2012