PHAYBOUN K KATTAVIRAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051289126

License Status

NOT RENEWED

Business

First Name

PHAYBOUN

Middle

Last Name

KATTAVIRAVONG

Business Name

PHAYBOUN K KATTAVIRAVONG

Original Issue Date

09/27/2002

Effective Date

01/24/2014

Expiration Date

03/31/2016

City

JONESBORO

State

Zip

72401

County

ARKANSAS

Ever Disciplined

LastModifiedDate

05/20/2016