OCTAVIA DENISE WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049303484

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60621

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2025