RAVEN R WALL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049243914

License Status

NOT RENEWED

Business

First Name

RAVEN

Middle

Last Name

WALL

Business Name

RAVEN R WALL

Original Issue Date

08/10/2016

Effective Date

08/10/2016

Expiration Date

03/31/2017

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/10/2017