MICHAEL WAYNE WALL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051031831

License Status

NOT RENEWED

Business

First Name

MICHAEL WAYNE

Last Name

WALL

Business Name

MICHAEL WAYNE WALL

Original Issue Date

08/18/1977

Effective Date

01/16/2018

Expiration Date

09/30/2020

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

01/14/2021