TIEN T PHAM Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209017737

License Status

INACTIVE

Business

First Name

TIEN

Middle

Last Name

PHAM

Business Name

TIEN T PHAM

Original Issue Date

05/29/2018

Effective Date

09/15/2020

Expiration Date

05/31/2022

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/15/2020