SIMALA INTHAVONG - Pharmacist License in Illinois | # 049205167

SIMALA INTHAVONG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049205167

License Status

NOT RENEWED

Business

N

First Name

SIMALA

Last Name

INTHAVONG

Business Name

SIMALA INTHAVONG

Original Issue Date

07/06/2011

Effective Date

07/06/2011

Expiration Date

03/31/2012

State

IL

Ever Disciplined

N

LastModifiedDate

05/07/2012