VET SONNY BOUTTAPHANH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158569

License Status

NOT RENEWED

Business

First Name

VET

Middle

SONNY

Last Name

BOUTTAPHANH

Business Name

VET SONNY BOUTTAPHANH

Original Issue Date

12/22/2004

Effective Date

12/22/2004

Expiration Date

03/31/2006

City

SYCAMORE

State

Zip

60178

County

DEKALB

Ever Disciplined

LastModifiedDate

05/11/2006