DOUGLAS LEE CLARK Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051029966

License Status

INACTIVE

Business

First Name

DOUGLAS LEE

Last Name

CLARK

Business Name

DOUGLAS LEE CLARK

Original Issue Date

08/02/1974

Effective Date

08/02/1974

Expiration Date

03/31/1998

City

MINOCQUA

State

Zip

54548

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005