CLARK ANTHONY PATUNGAN DEVENECIA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049267545

License Status

NOT RENEWED

Business

First Name

CLARK ANTHONY

Middle

PATUNGAN

Last Name

DEVENECIA

Business Name

CLARK ANTHONY PATUNGAN DEVENECIA

Original Issue Date

08/27/2019

Effective Date

01/10/2021

Expiration Date

05/31/2022

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022