TIMOTHY Z WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049193973

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

WALLACE

Business Name

TIMOTHY Z WALLACE

Original Issue Date

09/01/2009

Effective Date

02/07/2011

Expiration Date

03/31/2012

City

DEKALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

05/07/2012