MANISA PHOPHAIRAT BAKER - Advanced Practice Nurse License in Indiana | # 209006813

MANISA PHOPHAIRAT BAKER

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209006813

License Status

INACTIVE

Business

N

First Name

MANISA

Middle

PHOPHAIRAT

Last Name

BAKER

Business Name

MANISA PHOPHAIRAT BAKER

Original Issue Date

10/12/2007

Effective Date

06/29/2020

Expiration Date

08/31/2022

State

IN

Ever Disciplined

N

LastModifiedDate

06/14/2022