SENGTHAVONE BOUALAVONG - Pharmacist License in Illinois | # 049133730

SENGTHAVONE BOUALAVONG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133730

License Status

NOT RENEWED

Business

N

First Name

SENGTHAVONE

Last Name

BOUALAVONG

Business Name

SENGTHAVONE BOUALAVONG

Original Issue Date

11/22/2000

Effective Date

04/02/2018

Expiration Date

03/31/2019

State

IL

Ever Disciplined

N

LastModifiedDate

07/15/2019