JACQUELINE A MOO WALLIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049080455

License Status

NOT RENEWED

Business

First Name

JACQUELINE A MOO

Last Name

WALLIS

Business Name

JACQUELINE A MOO WALLIS

Original Issue Date

11/16/1984

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

HAMMOND

State

Zip

46324

County

INDIANA

Ever Disciplined

LastModifiedDate

05/14/2007