Kongsavanh Katty Phanthalasy
ExpiredIllinois license 049270580
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 049270580
- Status
- Expired (Not Renewed)
- First issued
- January 27, 2020
- Expired
- March 31, 2021
- License holder
- Kongsavanh Katty Phanthalasy
- Entity type
- Individual
Classifications
- Pharmacy Technician Pharmacy
More from the license record
- Current term began
- 01/27/2020
Contact
Louisville, KY 40222