NATHAN ANDREW CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049266988

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

ANDREW

Last Name

CLARK

Business Name

NATHAN ANDREW CLARK

Original Issue Date

07/31/2019

Effective Date

03/11/2021

Expiration Date

05/31/2022

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/27/2022