BRADEN WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049276000

License Status

NOT RENEWED

Business

First Name

BRADEN

Last Name

WALLACE

Business Name

BRADEN WALLACE

Original Issue Date

09/21/2020

Effective Date

01/10/2021

Expiration Date

05/31/2022

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/27/2022