SHAWNTAE RENAE WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049289596

License Status

NOT RENEWED

Business

First Name

SHAWNTAE

Middle

RENAE

Last Name

WALLACE

Business Name

SHAWNTAE RENAE WALLACE

Original Issue Date

01/13/2022

Effective Date

03/13/2023

Expiration Date

03/31/2024

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2025