TERESA RENEE WALLBAUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049186462

License Status

NOT RENEWED

Business

First Name

TERESA

Middle

RENEE

Last Name

WALLBAUM

Business Name

TERESA RENEE WALLBAUM

Original Issue Date

08/21/2008

Effective Date

02/19/2013

Expiration Date

03/31/2014

City

MOUNT CARMEL

State

Zip

62863

County

WABASH

Ever Disciplined

LastModifiedDate

05/06/2014