PONGSRI BOONTANONDA - Registered Nurse License in Illinois | # 041117436

PONGSRI BOONTANONDA

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041117436

License Status

INACTIVE

Business

N

First Name

PONGSRI

Last Name

BOONTANONDA

Business Name

PONGSRI BOONTANONDA

Original Issue Date

05/12/1966

Effective Date

05/12/1966

Expiration Date

05/31/1996

State

IL

Ever Disciplined

N

LastModifiedDate

09/27/2006