JUDITH A WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049101923

License Status

NOT RENEWED

Business

First Name

JUDITH A

Last Name

WALLACE

Business Name

JUDITH A WALLACE

Original Issue Date

12/07/1992

Effective Date

12/07/1992

Expiration Date

03/31/2005

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005