SOMPHAT PHONGSAVATH - Massage Therapist License in Illinois | # 227004922

SOMPHAT PHONGSAVATH

Business Entity

NOT RENEWED

License Type

Massage Therapist

Description

LICENSED MASSAGE THERAPIST

License Number

227004922

License Status

NOT RENEWED

Business

N

First Name

SOMPHAT

Last Name

PHONGSAVATH

Business Name

SOMPHAT PHONGSAVATH

Original Issue Date

09/22/2005

Effective Date

01/01/2007

Expiration Date

12/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

02/11/2009