SARA MARIE WALLACE - Pharmacist License in Wisconsin | # 049164093

SARA MARIE WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164093

License Status

NOT RENEWED

Business

N

First Name

SARA

Middle

MARIE

Last Name

WALLACE

Business Name

SARA MARIE WALLACE

Original Issue Date

09/21/2005

Effective Date

09/21/2005

Expiration Date

03/31/2006

State

WI

Ever Disciplined

N

LastModifiedDate

05/11/2006