BANLU VITAYAUDOM - Registered Nurse License in Illinois | # 041157798

BANLU VITAYAUDOM

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041157798

License Status

NOT RENEWED

Business

N

First Name

BANLU

Last Name

VITAYAUDOM

Business Name

BANLU VITAYAUDOM

Original Issue Date

09/11/1974

Effective Date

09/11/1974

Expiration Date

05/31/1996

State

IL

Ever Disciplined

N

LastModifiedDate

09/27/2006