SIRILAK BOUTTAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049179824

License Status

NOT RENEWED

Business

First Name

SIRILAK

Last Name

BOUTTAVONG

Business Name

SIRILAK BOUTTAVONG

Original Issue Date

10/09/2007

Effective Date

10/09/2007

Expiration Date

03/31/2008

City

JOLIET

State

Zip

60431

County

WILL

Ever Disciplined

LastModifiedDate

05/02/2008