Eric L Black - (Pharmacy)
Eric L Black, PIC
Mount Vernon, MO 62864
License# : 2014037458 - Issued on : 10/21/2014
Doing Business As : Mount Vernon Community Pharmacy
| Licensee Name: | Eric L Black |
| Profession Name: | Pharmacy |
| Licensee Number: | 2014037458 |
| Expiration Date: | 10/31/2017 |
| Original Issue Date: | 10/21/2014 |
| Address: | Eric L Black, PIC |
| Address Con't: | 2339 Broadway St |
| City, State Zip: | Mount Vernon, IL 62864 |
| County: | Unknown/Out of State |
| Practitioner DBA Name: | Mount Vernon Community Pharmacy |
| Classification: | Class A, D, H |
| Current Discipline Status: | None |
Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists
