SUPHA KRISSANASAMIT Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041139456

License Status

NOT RENEWED

Business

First Name

SUPHA

Last Name

KRISSANASAMIT

Business Name

SUPHA KRISSANASAMIT

Original Issue Date

06/17/1971

Effective Date

06/17/1971

Expiration Date

05/31/1994

City

CHICAGO

State

Zip

60638

County

COOK

Ever Disciplined

LastModifiedDate

09/27/2006