KATHLEEN ANN WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049204902

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

ANN

Last Name

WALLACE

Business Name

KATHLEEN ANN WALLACE

Original Issue Date

06/21/2011

Effective Date

06/21/2011

Expiration Date

03/31/2012

City

DAVENPORT

State

Zip

52806

County

IOWA

Ever Disciplined

LastModifiedDate

05/07/2012