SURASAK J VASAVANONT - Pharmacist License in Illinois | # 049127405

SURASAK J VASAVANONT

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049127405

License Status

INACTIVE

Business

N

First Name

SURASAK

Middle

J

Last Name

VASAVANONT

Business Name

SURASAK J VASAVANONT

Original Issue Date

09/14/1999

Effective Date

03/02/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

01/12/2010