BROOKE D WALLACE - Pharmacist License in Illinois | # 049129330

BROOKE D WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049129330

License Status

NOT RENEWED

Business

N

First Name

BROOKE

Middle

D

Last Name

WALLACE

Business Name

BROOKE D WALLACE

Original Issue Date

02/16/2000

Effective Date

02/16/2000

Expiration Date

03/31/2001

State

IL

Ever Disciplined

N

LastModifiedDate

10/21/2005