SITIHIAMPHONE PHETCHAMPHONE DC Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114085

License Status

NOT RENEWED

Business

First Name

SITIHIAMPHONE

Last Name

PHETCHAMPHONE

Suffix

Business Name

SITIHIAMPHONE PHETCHAMPHONE DC

Original Issue Date

04/25/1996

Effective Date

04/25/1996

Expiration Date

03/31/1997

City

JOLIET

State

Zip

60436

County

WILL

Ever Disciplined

LastModifiedDate

10/17/2005