ADA PHUTHAPHAN - Registered Nurse License in Illinois | # 041129894

ADA PHUTHAPHAN

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041129894

License Status

NOT RENEWED

Business

N

First Name

ADA

Last Name

PHUTHAPHAN

Business Name

ADA PHUTHAPHAN

Original Issue Date

02/10/1969

Effective Date

02/10/1969

Expiration Date

05/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006