JACQUELINE KHANH PHAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049225121

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Middle

KHANH

Last Name

PHAN

Business Name

JACQUELINE KHANH PHAN

Original Issue Date

05/12/2014

Effective Date

01/13/2015

Expiration Date

03/31/2016

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/20/2016