MICHELLE ANNE WALLENBERG - Pharmacist License in Illinois | # 049126632

MICHELLE ANNE WALLENBERG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049126632

License Status

NOT RENEWED

Business

N

First Name

MICHELLE

Middle

ANNE

Last Name

WALLENBERG

Business Name

MICHELLE ANNE WALLENBERG

Original Issue Date

07/07/1999

Effective Date

07/07/1999

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005