SUPA SOMBUTTAVEE - Registered Nurse License in Illinois | # 041125952

SUPA SOMBUTTAVEE

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041125952

License Status

NOT RENEWED

Business

N

First Name

SUPA

Last Name

SOMBUTTAVEE

Business Name

SUPA SOMBUTTAVEE

Original Issue Date

06/07/1968

Effective Date

06/07/1968

State

IL

Ever Disciplined

N

LastModifiedDate

09/27/2006