KIMBERLY RENEE WALLACE - Pharmacist License in Illinois | # 049131352

KIMBERLY RENEE WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131352

License Status

NOT RENEWED

Business

N

First Name

KIMBERLY

Middle

RENEE

Last Name

WALLACE

Business Name

KIMBERLY RENEE WALLACE

Original Issue Date

06/26/2000

Effective Date

06/26/2000

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005