KENYONA LYNN WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049290019

License Status

NOT RENEWED

Business

First Name

KENYONA

Middle

LYNN

Last Name

WALLACE

Business Name

KENYONA LYNN WALLACE

Original Issue Date

01/28/2022

Effective Date

01/28/2022

Expiration Date

03/31/2023

City

EDWARDSVILLE

State

Zip

62025

Ever Disciplined

LastModifiedDate

09/07/2023