BANYATLAX CHONGULIA Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041121466

License Status

INACTIVE

Business

First Name

BANYATLAX

Last Name

CHONGULIA

Business Name

BANYATLAX CHONGULIA

Original Issue Date

06/16/1967

Effective Date

06/16/1967

Expiration Date

05/31/1986

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

09/27/2006