SHANISE M WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049199095

License Status

NOT RENEWED

Business

First Name

SHANISE

Middle

Last Name

WALLACE

Prefix

Business Name

SHANISE M WALLACE

Original Issue Date

06/23/2010

Effective Date

02/26/2014

Expiration Date

03/31/2015

City

CHICAGO

State

Zip

60652

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2015