OCTAVIA DENISE WALLACE - Pharmacist License in Illinois | # 049303484

OCTAVIA DENISE WALLACE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049303484

License Status

NOT RENEWED

Business

N

First Name

OCTAVIA

Middle

DENISE

Last Name

WALLACE

Business Name

OCTAVIA DENISE WALLACE

Original Issue Date

06/26/2023

Effective Date

06/26/2023

Expiration Date

03/31/2024

State

IL

Ever Disciplined

N

LastModifiedDate

01/03/2025