SUPA BOONYOBHAS - Registered Nurse License in Illinois | # 041130782

SUPA BOONYOBHAS

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041130782

License Status

NOT RENEWED

Business

N

First Name

SUPA

Last Name

BOONYOBHAS

Business Name

SUPA BOONYOBHAS

Original Issue Date

05/09/1969

Effective Date

05/09/1969

Expiration Date

05/31/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006