KONGSAVANH KATTY PHANTHALASY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049270580

License Status

NOT RENEWED

Business

First Name

KONGSAVANH

Middle

KATTY

Last Name

PHANTHALASY

Business Name

KONGSAVANH KATTY PHANTHALASY

Original Issue Date

01/27/2020

Effective Date

01/27/2020

Expiration Date

03/31/2021

City

LOUISVILLE

State

Zip

40222

Ever Disciplined

LastModifiedDate

07/20/2021