JACOB SCOTT CLARK - Pharmacist License in Illinois | # 049196011

JACOB SCOTT CLARK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049196011

License Status

NOT RENEWED

Business

N

First Name

JACOB

Middle

SCOTT

Last Name

CLARK

Business Name

JACOB SCOTT CLARK

Original Issue Date

12/29/2009

Effective Date

11/16/2011

Expiration Date

03/31/2012

State

IL

Ever Disciplined

N

LastModifiedDate

05/07/2012