SUPATHRA POONGBUNKOR Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041153793

License Status

INACTIVE

Business

First Name

SUPATHRA

Last Name

POONGBUNKOR

Business Name

SUPATHRA POONGBUNKOR

Original Issue Date

02/22/1974

Effective Date

05/17/2010

Expiration Date

05/31/2012

City

DARIEN

State

Zip

60561

County

DUPAGE

Ever Disciplined

LastModifiedDate

03/08/2012