ROGER B THONGSAMOUTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049170103

License Status

NOT RENEWED

Business

First Name

ROGER

Middle

Last Name

THONGSAMOUTH

Business Name

ROGER B THONGSAMOUTH

Original Issue Date

07/19/2006

Effective Date

04/03/2017

Expiration Date

03/31/2018

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Ever Disciplined

LastModifiedDate

06/19/2018