BRIAN PHOUTHAVONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049304851

License Status

NOT RENEWED

Business

First Name

BRIAN

Last Name

PHOUTHAVONG

Business Name

BRIAN PHOUTHAVONG

Original Issue Date

08/09/2023

Effective Date

02/18/2024

Expiration Date

03/31/2025

City

CREST HILL

State

Zip

60403

County

WILL

Ever Disciplined

LastModifiedDate

07/08/2025