CHINTANA K SENGCHANNAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049172093

License Status

NOT RENEWED

Business

First Name

CHINTANA

Middle

Last Name

SENGCHANNAVONG

Business Name

CHINTANA K SENGCHANNAVONG

Original Issue Date

10/25/2006

Effective Date

03/17/2011

Expiration Date

03/31/2012

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/07/2012