DIANE E WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049066731

License Status

NOT RENEWED

Business

First Name

DIANE E

Last Name

WALLACE

Business Name

DIANE E WALLACE

Original Issue Date

01/28/1977

Effective Date

01/28/1977

Expiration Date

01/01/1997

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005