STACIE L WADE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049112499

License Status

NOT RENEWED

Business

First Name

STACIE L

Last Name

WADE

Business Name

STACIE L WADE

Original Issue Date

11/17/1995

Effective Date

11/17/1995

Expiration Date

03/31/1997

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005