RUSSELL EDWARD CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049202972

License Status

NOT RENEWED

Business

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

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/07/2012