JAY E WALLACE - Pharmacist License in Illinois | # 049115270

JAY E WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115270

License Status

NOT RENEWED

Business

N

First Name

JAY E

Last Name

WALLACE

Business Name

JAY E WALLACE

Original Issue Date

09/26/1996

Effective Date

09/26/1996

Expiration Date

03/31/1997

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005