ANSAM SR KOUK - Pharmacist License in Illinois | # 049278368

ANSAM SR KOUK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049278368

License Status

NOT RENEWED

Business

N

First Name

ANSAM

Middle

SR

Last Name

KOUK

Business Name

ANSAM SR KOUK

Original Issue Date

12/31/2020

Effective Date

12/31/2020

Expiration Date

03/31/2021

State

IL

Ever Disciplined

N

LastModifiedDate

07/20/2021