SUSAN KAY WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114142

License Status

NOT RENEWED

Business

First Name

SUSAN KAY

Last Name

WALLACE

Business Name

SUSAN KAY WALLACE

Original Issue Date

05/02/1996

Effective Date

02/20/2015

Expiration Date

03/31/2016

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/20/2016