SUPHAT SUBONGKOT - Pharmacist License in Illinois | # 049121864

SUPHAT SUBONGKOT

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049121864

License Status

NOT RENEWED

Business

N

First Name

SUPHAT

Last Name

SUBONGKOT

Business Name

SUPHAT SUBONGKOT

Original Issue Date

07/06/1998

Effective Date

07/06/1998

Expiration Date

03/31/2001

State

IL

Ever Disciplined

N

LastModifiedDate

10/21/2005