RUSSELL EDWARD CLARK - Pharmacist License in Illinois | # 049202972

RUSSELL EDWARD CLARK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049202972

License Status

NOT RENEWED

Business

N

First Name

RUSSELL

Middle

EDWARD

Last Name

CLARK

Business Name

RUSSELL EDWARD CLARK

Original Issue Date

03/02/2011

Effective Date

03/02/2011

Expiration Date

03/31/2012

State

IL

Ever Disciplined

N

LastModifiedDate

05/07/2012