RAVEN L WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049202013

License Status

NOT RENEWED

Business

First Name

RAVEN

Middle

Last Name

WALLACE

Prefix

Business Name

RAVEN L WALLACE

Original Issue Date

12/18/2010

Effective Date

12/18/2010

Expiration Date

03/31/2011

City

GLENWOOD

State

Zip

60425

County

COOK

Ever Disciplined

LastModifiedDate

05/12/2011