ARIEL INTHAVONG Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049254529

License Status

ACTIVE

Business

First Name

ARIEL

Last Name

INTHAVONG

Business Name

ARIEL INTHAVONG

Original Issue Date

11/30/2017

Effective Date

03/20/2025

Expiration Date

03/31/2026

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/30/2026