PHETCHALAD JACKIE SYPHOMMARATH - Pharmacist License in Illinois | # 049187247

PHETCHALAD JACKIE SYPHOMMARATH

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049187247

License Status

NOT RENEWED

Business

N

First Name

PHETCHALAD

Middle

JACKIE

Last Name

SYPHOMMARATH

Business Name

PHETCHALAD JACKIE SYPHOMMARATH

Original Issue Date

09/23/2008

Effective Date

03/15/2021

Expiration Date

05/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022