BRANDON MICHAEL KHAMMANIVONG - Pharmacist License in Illinois | # 049187991

BRANDON MICHAEL KHAMMANIVONG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049187991

License Status

NOT RENEWED

Business

N

First Name

BRANDON

Middle

MICHAEL

Last Name

KHAMMANIVONG

Business Name

BRANDON MICHAEL KHAMMANIVONG

Original Issue Date

10/27/2008

Effective Date

08/27/2010

Expiration Date

03/31/2011

State

IL

Ever Disciplined

N

LastModifiedDate

05/12/2011