MARYANNE CAPULONG NAVIENGKHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049190818

License Status

NOT RENEWED

Business

First Name

MARYANNE

Middle

CAPULONG

Last Name

NAVIENGKHAM

Business Name

MARYANNE CAPULONG NAVIENGKHAM

Original Issue Date

04/07/2009

Effective Date

04/12/2018

Expiration Date

03/31/2019

City

MELROSE PARK

State

Zip

60164

County

COOK

Ever Disciplined

LastModifiedDate

07/15/2019