JAY E WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115270

License Status

NOT RENEWED

Business

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

City

LA PLACE

State

Zip

61936

County

PIATT

Ever Disciplined

LastModifiedDate

10/17/2005