SHAWNTAE RENAE WALLACE - Pharmacist License in Illinois | # 049289596

SHAWNTAE RENAE WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049289596

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

01/03/2025