MARVETTA LOUISE WALLACE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049257476

License Status

NOT RENEWED

Business

First Name

MARVETTA

Middle

LOUISE

Last Name

WALLACE

Business Name

MARVETTA LOUISE WALLACE

Original Issue Date

04/11/2018

Effective Date

04/11/2018

Expiration Date

03/31/2019

City

KENOSHA

State

Zip

53144

Ever Disciplined

LastModifiedDate

07/15/2019