DAVID C WALLACE Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051287512

License Status

INACTIVE

Business

First Name

DAVID

Middle

Last Name

WALLACE

Business Name

DAVID C WALLACE

Original Issue Date

12/07/1999

Effective Date

12/07/1999

Expiration Date

03/31/2004

City

AUBURN

State

Zip

98092

Ever Disciplined

LastModifiedDate

12/06/2005