BONITA WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049141100

License Status

NOT RENEWED

Business

First Name

BONITA

Last Name

WALLACE

Business Name

BONITA WALLACE

Original Issue Date

03/01/2002

Effective Date

03/01/2002

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60609

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005