MANTHINH KINGSAVANH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049263484

License Status

NOT RENEWED

Business

First Name

MANTHINH

Last Name

KINGSAVANH

Business Name

MANTHINH KINGSAVANH

Original Issue Date

02/20/2019

Effective Date

02/20/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/08/2021