JAMES RUSSELL WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049063536

License Status

NOT RENEWED

Business

First Name

JAMES RUSSELL

Last Name

WALLACE

Business Name

JAMES RUSSELL WALLACE

Original Issue Date

05/23/1975

Effective Date

05/23/1975

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005