License holder summary

Jay Suryaputra Wirawan is a Pharmacy - Pharmacist Intern licensed to practice in Colorado. The address on file for Jay Suryaputra Wirawan is 2100 S 260th St Apt M302, Des Moines, WA, 98198-8198. This licensed professional license is not current. The license was granted 09/13/2006 and expired on 10/31/2011.

Colorado

Division of Professions and Occupations

Jay Suryaputra Wirawan
Pharmacy - Pharmacist Intern
License number
2003242
Date granted
09/13/2006
Date expires
10/31/2011
Class
Pharmacy - Pharmacist Intern
Status
Expired
Address
2100 S 260th St Apt M302, Des Moines, WA, 98198-8198
coloradolicensing.org
ID 28202057
LAST UPDATED 2026-06-09 02:49:17 UTC

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