GRACIE NICOLE CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049225913

License Status

NOT RENEWED

Business

First Name

GRACIE

Middle

NICOLE

Last Name

CLARK

Prefix

Business Name

GRACIE NICOLE CLARK

Original Issue Date

06/14/2014

Effective Date

02/12/2020

Expiration Date

03/31/2021

City

BONNIE

State

Zip

62816

County

JEFFERSON

Ever Disciplined

LastModifiedDate

07/20/2021