DANIEL D WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049170233

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

WALLACE

Business Name

DANIEL D WALLACE

Original Issue Date

07/26/2006

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/02/2008