DEMETRIUNA NICOLE WALLACE Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049246418

License Status

ACTIVE

Business

First Name

DEMETRIUNA

Middle

NICOLE

Last Name

WALLACE

Business Name

DEMETRIUNA NICOLE WALLACE

Original Issue Date

11/18/2016

Effective Date

02/04/2026

Expiration Date

03/31/2027

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/04/2026