KELLY RAE WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049183836

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

RAE

Last Name

WALLACE

Business Name

KELLY RAE WALLACE

Original Issue Date

04/23/2008

Effective Date

04/23/2008

Expiration Date

03/31/2009

City

MARSHALL

State

Zip

62441

County

CLARK

Ever Disciplined

LastModifiedDate

05/06/2009