ROGER F CLARK Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051026983

License Status

INACTIVE

Business

First Name

ROGER F

Last Name

CLARK

Business Name

ROGER F CLARK

Original Issue Date

01/01/1997

Effective Date

03/22/2010

Expiration Date

03/31/2012

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/12/2012