BRADEN WALLACE - Pharmacist License in Illinois | # 049276000

BRADEN WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049276000

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022