KALLAYA EURSIRIWAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049075450

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60660

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005