The holder whose full name is Phetsomphou, Bousaba,come from Indianapolis IN,hold the Pharmacy Technician license(NO.67007330A) which status is Expired.
| Name | Phetsomphou, Bousaba |
|---|---|
| License Number | 67007330A |
| License Type | Pharmacy Technician |
| License Status | Expired |
| City | Indianapolis |
| State | IN |