BROOKE D WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049129330

License Status

NOT RENEWED

Business

First Name

BROOKE

Middle

Last Name

WALLACE

Business Name

BROOKE D WALLACE

Original Issue Date

02/16/2000

Effective Date

02/16/2000

Expiration Date

03/31/2001

City

FLANAGAN

State

Zip

61740

County

LIVINGSTON

Ever Disciplined

LastModifiedDate

10/21/2005