LILLIAN IRENE WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049205161

License Status

NOT RENEWED

Business

First Name

LILLIAN

Middle

IRENE

Last Name

WALLACE

Business Name

LILLIAN IRENE WALLACE

Original Issue Date

07/06/2011

Effective Date

03/12/2015

Expiration Date

03/31/2016

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/20/2016