LATASHA D WALLACE - Pharmacist License in Illinois | # 049183366

LATASHA D WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049183366

License Status

NOT RENEWED

Business

N

First Name

LATASHA

Middle

D

Last Name

WALLACE

Prefix

MR

Business Name

LATASHA D WALLACE

Original Issue Date

04/06/2008

Effective Date

04/06/2008

Expiration Date

03/31/2009

State

IL

Ever Disciplined

N

LastModifiedDate

05/06/2009