MICA L WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049095426

License Status

NOT RENEWED

Business

First Name

MICA

Middle

Last Name

WALLACE

Business Name

MICA L WALLACE

Original Issue Date

12/21/1990

Effective Date

02/19/2013

Expiration Date

03/31/2014

City

LANSING

State

Zip

60438

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2014