TIPAWAN PHOLPITUCKSA - Registered Nurse License in Illinois | # 041113425

TIPAWAN PHOLPITUCKSA

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041113425

License Status

NOT RENEWED

Business

N

First Name

TIPAWAN

Last Name

PHOLPITUCKSA

Business Name

TIPAWAN PHOLPITUCKSA

Original Issue Date

04/01/1965

Effective Date

04/01/1965

Expiration Date

05/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

07/11/2008