VET SONNY BOUTTAPHANH - Pharmacist License in Illinois | # 049158569

VET SONNY BOUTTAPHANH

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158569

License Status

NOT RENEWED

Business

N

First Name

VET

Middle

SONNY

Last Name

BOUTTAPHANH

Business Name

VET SONNY BOUTTAPHANH

Original Issue Date

12/22/2004

Effective Date

12/22/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006