CHANH PHASOUK LEWIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049206944

License Status

NOT RENEWED

Business

First Name

CHANH

Last Name

PHASOUK LEWIS

Business Name

CHANH PHASOUK LEWIS

Original Issue Date

09/26/2011

Effective Date

04/01/2013

Expiration Date

03/31/2014

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/06/2014