BRAD ALEXANDER WALLEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049263731

License Status

NOT RENEWED

Business

First Name

BRAD

Middle

ALEXANDER

Last Name

WALLEN

Business Name

BRAD ALEXANDER WALLEN

Original Issue Date

03/14/2019

Effective Date

01/04/2020

Expiration Date

03/31/2021

City

SIDELL

State

Zip

61876

County

VERMILION

Ever Disciplined

LastModifiedDate

07/20/2021