SUPANG DHEPYASUWAN - Registered Nurse License in Illinois | # 041124458

SUPANG DHEPYASUWAN

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041124458

License Status

INACTIVE

Business

N

First Name

SUPANG

Last Name

DHEPYASUWAN

Business Name

SUPANG DHEPYASUWAN

Original Issue Date

12/13/1967

Effective Date

12/13/1967

Expiration Date

05/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006