MIA GRACE DALLY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049277212

License Status

NOT RENEWED

Business

First Name

MIA

Middle

GRACE

Last Name

DALLY

Business Name

MIA GRACE DALLY

Original Issue Date

11/05/2020

Effective Date

05/25/2022

Expiration Date

03/31/2023

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/07/2023