LATASHA ANN CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049264395

License Status

NOT RENEWED

Business

First Name

LATASHA

Middle

ANN

Last Name

CLARK

Business Name

LATASHA ANN CLARK

Original Issue Date

04/11/2019

Effective Date

03/16/2020

Expiration Date

03/31/2021

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

07/20/2021