VANNAK CHOUP CHIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155446

License Status

NOT RENEWED

Business

First Name

VANNAK

Middle

CHOUP

Last Name

CHIN

Business Name

VANNAK CHOUP CHIN

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

03/31/2006

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

05/11/2006