CLIFFORD G WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051025489

License Status

NOT RENEWED

Business

First Name

CLIFFORD G

Last Name

WALLACE

Business Name

CLIFFORD G WALLACE

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005