KEITH ALAN WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049180061

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

ALAN

Last Name

WALLACE

Business Name

KEITH ALAN WALLACE

Original Issue Date

10/19/2007

Effective Date

10/19/2007

Expiration Date

03/31/2008

City

SAINT PETERS

State

Zip

63376

County

MISSOURI

Ever Disciplined

LastModifiedDate

05/02/2008