KALLAYA EURSIRIWAN - Pharmacist License in Illinois | # 049075450

KALLAYA EURSIRIWAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049075450

License Status

NOT RENEWED

Business

N

First Name

KALLAYA

Last Name

EURSIRIWAN

Business Name

KALLAYA EURSIRIWAN

Original Issue Date

10/09/1981

Effective Date

10/09/1981

Expiration Date

03/31/1982

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005