Sourathda Asjah Syphommarath
ExpiredIllinois license 049252724
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 049252724
- Status
- Expired (Not Renewed)
- First issued
- September 6, 2017
- Expired
- March 31, 2019
- License holder
- Sourathda Asjah Syphommarath
- Entity type
- Individual
Classifications
- Pharmacy Technician Pharmacy
More from the license record
- Current term began
- 03/23/2018
Contact
Loves Park, IL 61111
Winnebago County