RICHARD LEE BLACK Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051032788

License Status

INACTIVE

Business

First Name

RICHARD LEE

Last Name

BLACK

Business Name

RICHARD LEE BLACK

Original Issue Date

08/07/1979

Effective Date

08/07/1979

Expiration Date

03/31/2004

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

12/06/2005