SIMALA INTHAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049205327

License Status

NOT RENEWED

Business

First Name

SIMALA

Last Name

INTHAVONG

Business Name

SIMALA INTHAVONG

Original Issue Date

07/13/2011

Effective Date

07/13/2011

Expiration Date

03/31/2012

City

ELGIN

State

Zip

60120

County

KANE

Ever Disciplined

LastModifiedDate

05/07/2012