SUPA SOMBUTTAVEE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041125952

License Status

NOT RENEWED

Business

First Name

SUPA

Last Name

SOMBUTTAVEE

Business Name

SUPA SOMBUTTAVEE

Original Issue Date

06/07/1968

Effective Date

06/07/1968

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/27/2006