POOME CHAMNANKIT Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

INACTIVE

Business

First Name

POOME

Last Name

CHAMNANKIT

Business Name

POOME CHAMNANKIT

Original Issue Date

07/19/2005

Effective Date

04/30/2024

Expiration Date

05/31/2026

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/03/2024