MARK EDWARD HUMPHREY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051030021

License Status

NOT RENEWED

Business

First Name

MARK

Middle

EDWARD

Last Name

HUMPHREY

Business Name

MARK EDWARD HUMPHREY

Original Issue Date

08/02/1974

Effective Date

02/22/2016

Expiration Date

03/31/2018

City

CREAL SPRINGS

State

Zip

62922

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

06/19/2018