MISTY BRIANNA PHOMMATHETH Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209026926

License Status

NOT RENEWED

Business

First Name

MISTY

Middle

BRIANNA

Last Name

PHOMMATHETH

Business Name

MISTY BRIANNA PHOMMATHETH

Original Issue Date

03/20/2023

Effective Date

03/20/2023

Expiration Date

06/30/2024

City

CHICO

State

Zip

95928

Ever Disciplined

LastModifiedDate

02/05/2025