AMPHONE KINGPHAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049214918

License Status

NOT RENEWED

Business

First Name

AMPHONE

Last Name

KINGPHAVONG

Business Name

AMPHONE KINGPHAVONG

Original Issue Date

12/06/2012

Effective Date

03/25/2015

Expiration Date

03/31/2016

City

BELVIDERE

State

Zip

61008

County

BOONE

Ever Disciplined

LastModifiedDate

05/20/2016