SENGTHAVONE BOUALAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133730

License Status

NOT RENEWED

Business

First Name

SENGTHAVONE

Last Name

BOUALAVONG

Business Name

SENGTHAVONE BOUALAVONG

Original Issue Date

11/22/2000

Effective Date

04/02/2018

Expiration Date

03/31/2019

City

CHATHAM

State

Zip

62629

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/15/2019