SAMANTHA RENEE VANISAVATH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049191484

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

RENEE

Last Name

VANISAVATH

Business Name

SAMANTHA RENEE VANISAVATH

Original Issue Date

05/05/2009

Effective Date

03/22/2010

Expiration Date

03/31/2011

City

MANASSAS

State

Zip

20110

County

VIRGINIA

Ever Disciplined

LastModifiedDate

05/12/2011