Stacey Lou Wallace
Revoked or deniedIllinois license 049142004
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 049142004
- Status
- Revoked or denied (Refuse To Renew)
- First issued
- April 24, 2002
- Expired
- March 31, 2010
- License holder
- Stacey Lou Wallace
- Entity type
- Individual
Classifications
- Pharmacy Technician Pharmacy
More from the license record
- Current term began
- 01/30/2009
- Ever disciplined
- Yes
- Discipline case
- 2010001778
- Discipline action
- Refuse To Renew
- Discipline reason
- For Forging Prescriptions for the Purpose of Causing Controlled Substances to Be Dispensed to Another Individual Over A Period of Approximately Two Years.
- Discipline dates
- 08/10/2010
Contact
Havana, IL 62644
Mason County