Nitdavanh Rose Syphommarath
ExpiredIllinois license 049286936
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 049286936
- Status
- Expired (Not Renewed)
- First issued
- October 25, 2021
- Expired
- March 31, 2024
- License holder
- Nitdavanh Rose Syphommarath
- Entity type
- Individual
Classifications
- Pharmacy Technician Pharmacy
More from the license record
- Current term began
- 04/01/2023
Contact
Rockford, IL 61108
Winnebago County