SARA MARIE WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164093

License Status

NOT RENEWED

Business

First Name

SARA

Middle

MARIE

Last Name

WALLACE

Business Name

SARA MARIE WALLACE

Original Issue Date

09/21/2005

Effective Date

09/21/2005

Expiration Date

03/31/2006

City

GENOA CITY

State

Zip

53128

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/11/2006