KAYLA A CLARK MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049185567

License Status

NOT RENEWED

Business

Title

First Name

KAYLA

Middle

Last Name

CLARK

Business Name

KAYLA A CLARK MD

Original Issue Date

07/15/2008

Effective Date

03/25/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010