KELLY C CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164637

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

CLARK

Business Name

KELLY C CLARK

Original Issue Date

10/27/2005

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/14/2007